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MARY HITCHCOCK MEMORIAL HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
MARY HITCHCOCK MEMORIAL HOSPITAL (EIN 02-0222140)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-12
IRS object ID
202241329349306474
Schema version
2020v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-12T15:31:55-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19600 Brownsboro Road Suite 400AddressLine1Txt
CityLouisvilleCityNm
State AbbreviationKYStateAbbreviationCd
ZIP402413902ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020222140EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mary Hitchcock Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMARYBusinessNameControlTxt
Phone6038631583PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Medical Center DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWendy E FieldingPersonNm
Person TitleCFO (effective 12/2021)PersonTitleTxt
Signature2022-05-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstWendy EPersonFirstNm
Person LastFieldingPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim ScifresPreparerPersonNm
PTINP01316095PTIN
Phone5023263996PhoneNum
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1JOANNE M CONROY MDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Medical Center DriveAddressLine1Txt
CityLebanonCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,607,422,213GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.DARTMOUTH-HITCHCOCK.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1889FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionADVANCING HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, COMMUNITY PARTNERSHIPS; PROVIDING EACH PERSON THE BEST CARE IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.ActivityOrMissionDesc
Voting Members Governing Body22VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee6691TotalEmployeeCnt
Total Volunteers193TotalVolunteersCnt
Total Gross UBI$39,399,502TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$34,484,885PYContributionsGrantsAmt
CY Contributions Grants$56,339,886CYContributionsGrantsAmt
PY Program Service Revenue$1,295,443,322PYProgramServiceRevenueAmt
CY Program Service Revenue$1,482,853,925CYProgramServiceRevenueAmt
PY Investment Income$18,523,480PYInvestmentIncomeAmt
CY Investment Income$2,939,087CYInvestmentIncomeAmt
PY Other Revenue$106,532,953PYOtherRevenueAmt
CY Other Revenue$64,631,506CYOtherRevenueAmt
PY Total Revenue$1,454,984,640PYTotalRevenueAmt
CY Total Revenue$1,606,764,404CYTotalRevenueAmt
PY Grants And Similar Paid$10,933,352PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$9,492,504CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$818,348,129PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$848,920,676CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$242,952CYTotalFundraisingExpenseAmt
PY Other Expenses$650,046,324PYOtherExpensesAmt
CY Other Expenses$703,131,476CYOtherExpensesAmt
PY Total Expenses$1,479,327,805PYTotalExpensesAmt
CY Total Expenses$1,561,544,656CYTotalExpensesAmt
PY Revenues Less Expenses-$24,343,165PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$45,219,748CYRevenuesLessExpensesAmt
Total Assets BOY$2,041,764,780TotalAssetsBOYAmt
Total Assets EOY$2,230,652,721TotalAssetsEOYAmt
Total Liabilities BOY$1,392,639,404TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,344,715,315TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$649,125,376NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$885,937,406NetAssetsOrFundBalancesEOYAmt
MissionWE ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,186,611,038ExpenseAmt
Grant$9,492,504GrantAmt
Revenue$1,438,408,531RevenueAmt
DescMARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) IS AN ACUTE AND TERTIARY CARE TEACHING HOSPITAL LOCATED IN LEBANON, NEW HAMPSHIRE. MHMH PROVIDES A BROAD RANGE OF PATIENT SERVICES AND HEALTH-RELATED COMMUNITY SERVICES, CONSISTENT WITH ITS ROLE AS A MAJOR TEACHING HOSPITAL, A TERTIARY CARE REFERRAL HOSPITAL, AND AS A PROSPECTIVE PAYMENT SYSTEM HOSPITAL (AS DEFINED BY CMS). MHMH PROVIDES A FULL RANGE OF SERVICES IN BOTH ACUTE AND CRITICAL MEDICINE, SURGERY, PSYCHIATRY AND REHABILITATION FOR INFANTS, CHILDREN AND ADULTS. DURING FY 2021, MHMH PROVIDED 132,486 ACUTE PATIENT DAYS OF INPATIENT SERVICE AND HAD 27,446 TOTAL ACUTE CARE DISCHARGES, WHILE MHMH'S EMERGENCY ROOM WAS OPEN TO THE PUBLIC 24 HOURS PER DAY, 7 DAYS PER WEEK AND HAD 27,108 DISCHARGES. DARTMOUTH-HITCHCOCK CLINIC (DHC) PROVIDES THE PHYSICIAN STAFF FOR THE HOSPITAL AND THE SOPHISTICATION ESSENTIAL FOR THE DEVELOPMENT OF THE HOSPITAL AS THE LARGEST AND ONLY TEACHING HOSPITAL IN NEW HAMPSHIRE AND THE DESIGNATION BY THE FEDERAL GOVERNMENT AS A RURAL REFERRAL CENTER FOR NORTHERN NEW ENGLAND. THE SHARED MISSION OF MHMH AND DHC IS TO ADVANCE HEALTH THROUGH RESEARCH, EDUCATION, CLINICAL PRACTICE, AND COMMUNITY PARTNERSHIPS, PROVIDING EACH PERSON THE BEST CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME, EVERY TIME. CONSISTENT WITH THIS MISSION AND IN PARTNERSHIP WITH DHC, MHMH PROVIDES HIGH-QUALITY, COST-EFFECTIVE, COMPREHENSIVE, AND INTEGRATED HEALTH CARE TO INDIVIDUALS, FAMILIES, AND THE COMMUNITIES IT SERVES, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THROUGH FORMAL AFFILIATIONS AND OTHER CLINICAL COLLABORATIONS, MHMH ALSO SEEKS TO PARTNER WITH OTHER AREA HEALTH CARE PROVIDERS TO IMPROVE THE HEALTH STATUS OF THE REGION. THE JACK BYRNE CENTER FOR PALLIATIVE & HOSPICE CARE COORDINATES MHMH'S CLINICAL, EDUCATIONAL, AND RESEARCH EFFORTS AND VISITING NURSE ALLIANCES AROUND THE REGION TO OFFER MUCH-NEEDED END-OF-LIFE CARE FOR PATIENTS IN A CLINICAL SETTING THAT MEETS THE NEEDS OF PATIENTS AND THEIR FAMILIES. MHMH ALSO CONTINUES TO BUILD ITS TELE-MEDICINE PROGRAM TO PROVIDE CARE ACROSS ITS RURAL REGION AND IN PARTICULAR TO MAKE SPECIALIST CONSULTATION AND CARE AVAILABLE TO CRITICAL ACCESS AND COMMUNITY HOSPITALS. THIS ALLOWS CAREGIVERS AT REMOTE LOCATIONS TO ACCESS SPECIALISTS AT MHMH AND DHC AND TO BRING THEM "VIRTUALLY" TO THE PATIENT'S BEDSIDE. MHMH'S CONNECTED CARE CENTER FOR TELE-HEALTH IN LEBANON OFFERS A 24/7 TEAM OF PHYSICIANS, PHARMACISTS, AND NURSES SUPPORTING THE FOLLOWING ACUTE CARE TELE-HEALTH SERVICE LINES: TELE-EMERGENCY, TELE-PHARMACY, TELE-NEUROLOGY, TELE-ICU, TELE-PSYCHIATRY, AND TELE-NEONATOLOGY; OUTPATIENT TELE-URGENT CARE 7 DAYS/WEEK; AND OUTPATIENT VIRTUAL VISITS IN PEDIATRICS AND MORE THAN 30 SPECIALTY SERVICES TO PATIENTS IN 17 CLINICAL LOCATIONS ALONG WITH PATIENT HOMES. MHMH SERVED AS ONE OF THE LEAD ORGANIZATIONS IN THE STATE-WIDE, FEDERALLY FUNDED DELIVERY SYSTEM REFORM INCENTIVE PROGRAM (DSRIP) FROM 2016-2021. THIS NH PROGRAM WAS FUNDED FROM 2016-2020 BUT GRANT FUNDING WAS ABLE TO BE CARRIED OVER FOR AN ADDITIONAL YEAR OF INTERVENTIONS AND ALL WORK WAS COMPLETED BY 31ST OF DECEMBER, 2021. DARTMOUTH-HITCHCOCK CLINIC AND CHESHIRE MEDICAL CENTER CO-SPONSORED THE DEVELOPMENT OF AN INTEGRATED DELIVERY NETWORK WHICH BROUGHT HEALTH SYSTEMS, COMMUNITY MENTAL HEALTH CENTERS, AND SOCIAL SERVICE ORGANIZATIONS TOGETHER TO COLLABORATE ON IMPROVING HEALTH FOR MEDICAID BENEFICIARIES WITH MENTAL HEALTH DISEASES AND/OR SUBSTANCE USE DISORDERS. WHILE DSRIP FUNDING HAS NOW EXPIRED, THIS WORK LAID THE FOUNDATION FOR ONGOING PROGRAMMING AND IN AUGUST 2021, MHMH WAS AWARDED A HRSA GRANT TO DEVELOP THE BEHAVIORAL WORKFORCE IN RURAL NEW HAMPSHIRE. MHMH HAS ALSO PARTNERED WITH COLBY-SAWYER COLLEGE TO PROVIDE NURSING EDUCATION TO BOTH COLBY-SAWYER STUDENTS AND TO MHMH STAFF. MHMH ALSO SPONSORS NUMEROUS TRAINING PROGRAMS THROUGH THE WORKFORCE READINESS INSTITUTE, A DEPARTMENT OF MHMH FOCUSED ON PROVIDING TRAINING PATHWAYS FOR ENTRY-LEVEL STAFF TO GAIN THE NECESSARY EDUCATION AND CERTIFICATIONS TO MOVE INTO HIGHER-PAYING ROLES. ALONG WITH PROVIDING FLU CLINICS TO BRING VACCINATIONS TO AREA COMMUNITIES, MHMH ALSO CREATED A COMMUNITY COVID TESTING CENTER DURING THE LATTER PART OF FY '20 WHICH REMAINED ACTIVE THROUGHOUT FY21. ADDITIONALLY, MHMH AND DHC HAVE SERVED BOTH THE STATE OF NEW HAMPSHIRE AND AREA COMMUNITIES AS "SUBJECT MATTER EXPERTS" DURING THE COVID PANDEMIC. DURING FY '20, MHMH COMMENCED CONSTRUCTION OF A NEW PATIENT PAVILION, EXPANDING ITS CURRENT IN-PATIENT CAPACITY AT THE LEBANON CAMPUS. (FOR THE PREVIOUS THREE YEARS, MHMH HAS TURNED AWAY ALMOST 2,500 PATIENTS PER YEAR BECAUSE THE HOSPITAL WAS AT FULL CAPACITY DURING THE PATIENTS' TIME OF NEED.) EXPECTED TO BE COMPLETED EARLY IN FY '23, THE PROJECT WILL COST IN EXCESS OF $100 MILLION AND WILL EXPAND IN-PATIENT CAPACITY TO MORE FULLY MEET THE ACUTE-CARE NEEDS OF THE REGION. MHMH AND DHC JOINTLY FILE AN ANNUAL COMMUNITY BENEFITS REPORT WITH THE STATE OF NEW HAMPSHIRE WHICH OUTLINES THE COMMUNITY AND CHARITABLE BENEFITS MHMH AND DHC PROVIDE. THE MOST RECENT COMMUNITY BENEFITS REPORT IS AVAILABLE BY REQUEST. FINANCIAL ASSISTANCE (FORMERLY CALLED "CHARITY CARE") REPRESENTS SERVICES PROVIDED TO PATIENTS WHO CANNOT AFFORD HEALTH CARE SERVICES DUE TO INADEQUATE FINANCIAL RESOURCES WHICH RESULT FROM BEING UNINSURED OR UNDERINSURED. FOR THE YEAR ENDED JUNE 30, 2021, MHMH PROVIDED FINANCIAL ASSISTANCE TO 13,540 PATIENTS IN THE AMOUNT OF $15,768,823 AS MEASURED BY GROSS CHARGES AND $22,023,967 FOR THE YEAR ENDED JUNE 30,2020. MHMH ALSO ROUTINELY PROVIDES SERVICES TO MEDICAID PATIENTS AT REIMBURSEMENT LEVELS THAT ARE BELOW THE COST OF THE CARE PROVIDED. THE COMMUNITY HEALTH ACTIVITIES NOTED INCLUDE THE COST OR VALUE OF SEVERAL DIFFERENT TYPES OF PROGRAMS INCLUDING THE COST OF COMMUNITY-BASED EDUCATION, HEALTH FAIRS, HEALTH SCREENINGS, SUPPORT GROUPS, AND PROGRAMS AND MATERIALS THAT PROMOTE WELLNESS AND PREVENT ILLNESS. EXAMPLES OF THESE TYPES OF EFFORTS INCLUDE PARTNERING WITH THE HEALTHY EATING ACTIVE LIVING NH INITIATIVE, THE WOMEN'S HEALTH RESOURCE CENTER, AND SMOKING PREVENTION AND CESSATION. THIS CATEGORY OF SUPPORT ALSO INCLUDES FINANCIAL CONTRIBUTIONS AND THE CONTRIBUTION OF TIME AND SERVICES TO COMMUNITY PROGRAMS, HOSPITALS AND AGENCIES. MHMH ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE TO ITS PATIENTS THAT IS REPORTED AS PROVISION FOR BAD DEBT, WHICH IS NOT INCLUDED IN THE AMOUNTS REPORTED ABOVE. DURING THE YEAR ENDED JUNE 30, 2021, THE HOSPITAL REPORTED A PROVISION FOR BAD DEBT OF $50,345,036.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$101,838,803ExpenseAmt
Revenue$67,243,803RevenueAmt
DescAS A COMPONENT OF NEW HAMPSHIRE'S ONLY INTEGRATED ACADEMIC MEDICAL CENTER, MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) PROVIDES THE GEISEL SCHOOL OF MEDICINE AT DARTMOUTH (GSM) SUPPORT FOR PHYSICIANS' UNPAID TEACHING TIME AS PART OF ITS COMMUNITY BENEFIT INITIATIVES. THIS SUPPORT CONSISTS OF THE TIME PHYSICIANS SPEND PROVIDING CLINICAL SUPERVISION AND EDUCATION FOR RESIDENTS AND MEDICAL STUDENTS. IN ADDITION, THE HOSPITAL PROVIDES IN-KIND SUPPORT FOR RESEARCH AND OTHER GRANTS REPRESENTING COSTS IN EXCESS OF AWARDS FOR NUMEROUS GRANT-FUNDED HEALTH RESEARCH AND SERVICE INITIATIVES AWARDED TO DARTMOUTH-HITCHCOCK CLINIC (DHC) AND GSM. OTHER COMMUNITY BENEFIT INITIATIVES INCLUDE SUBSIDIZING THE COSTS OF PROVIDING MEDICAL AND CLINICAL EDUCATION TO PROFESSIONALS ACROSS NEW HAMPSHIRE, VERMONT AND BEYOND AS WELL AS UNCOMPENSATED COSTS OF ACADEMIC AND MEDICAL RESEARCH ACTIVITIES. IN FY21, MHMH CONTINUED THE TRANSITION OF RESEARCH ACTIVITIES AND MANAGEMENT FROM GSM TO MHMH UNDER THE LEADERSHIP OF THE VICE PRESIDENT FOR RESEARCH OPERATIONS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,288,449,841TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgYes (true)MoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1345IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee6691EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members22GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Wendy E FieldingBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6036535634PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE MEDICAL CENTER DRIVEAddressLine1Txt
CityLEBANONCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (51 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Charles G Plimpton MBA
Trustee/Secretary/Treasurer1.52.5Yes (X)Yes (X)$0$0$0
Joanne M Conroy MD
Trustee, Ex-Officio, CEO37.818.3Yes (X)Yes (X)$0$1,481,660$47,969
Aaron J Mancuso MD
Trustee (Eff. 6/1/21) / Physician12.028.0Yes (X)$0$461,261$53,200
Carl W Dobson MD
Trustee (eff. 1/1/21) / Medical Director40.00.8Yes (X)$465,308$0$55,977
Cherie Holmes MD
Trustee (thru 12/31/20)/Physician28.013.0Yes (X)$0$526,558$45,791
David P Paul
Trustee0.80.8Yes (X)$0$0$0
Duane A Compton PHD
Trustee / Ex-Officio0.81.7Yes (X)$0$0$0
Edward H Stansfield III MA
Trustee/ Chair0.82.3Yes (X)$0$0$0
Elof Eriksson MD PhD
Trustee0.80.8Yes (X)$0$0$0
Gary L Freed MD
Trustee (effective 1/1/21) / Physician12.028.0Yes (X)$0$764,624$29,585
Geraldine Bednash PHD RN FAAN
Trustee (Effective 1/1/21)0.80.8Yes (X)$0$0$0
Jennifer L Moyer MBA
Trustee0.80.8Yes (X)$0$0$0
Jocelyn Chertoff MD
VP Service Line / DPT CHR Diagnostic Radiology28.012.0Yes (X)$0$739,732$46,322
Jon Wahrenberger MDFAHAFAC
Trustee (thru 12/31/20) / Physician28.012.0Yes (X)$0$297,749$61,933
JONATHAN HUNTINGTON MD PhD MPH
TRUSTEE (thru 5/31/21) / Academics CMO0.540.0Yes (X)$0$473,151$63,118
KURT K RHYNHART MD
TRUSTEE/Divisional Chief of Trauma28.012.0Yes (X)$0$501,615$49,261
Laura K Landy MBA
Trustee0.81.3Yes (X)$0$0$0
Marc B Wolpow JDMBA
Trustee0.81.3Yes (X)$0$0$0
Mark W Begor MBA
Trustee0.80.8Yes (X)$0$0$0
Pamela Thompson MSRNCENP
Trustee0.81.3Yes (X)$0$0$0
Paul P Danos PHD
Trustee0.81.3Yes (X)$0$0$0
Robert A Oden Jr PHD
Trustee (thru 12/31/20)1.52.5Yes (X)$0$0$0
Robert SD Higgins MD
Trustee (Effective 1/1/21)0.80.8Yes (X)$0$0$0
ROBERTA L HINES MD
TRUSTEE1.51.5Yes (X)$0$0$0
Thomas Glynn PHD
Trustee (Effective 1/1/21)0.80.8Yes (X)$0$0$0
Thomas Raffio
Trustee0.80.8Yes (X)$0$0$0
William J Conaty
Trustee (thru 12/31/20)0.81.3Yes (X)$0$0$0
Aimee M Claiborne
Chief HR Officer28.012.0Yes (X)$469,738$0$59,886
DANIEL P JANTZEN
Chief Financial Officer39.018.0Yes (X)$795,941$0$60,997
EDWARD MERRENS
Chief Clinical Officer28.013.0Yes (X)$0$739,353$47,445
JOHN KACAVAS
Chief Legal Officer28.015.0Yes (X)$727,649$0$66,274
Maria Padin MD
Chief Medical Officer28.014.0Yes (X)$0$552,590$70,033
Martin Purcell MBA
Chief Information Officer28.012.0Yes (X)$470,064$0$55,569
Matthew Haag
VP Development28.012.0Yes (X)$443,871$0$39,136
Patrick F Jordan III MBA
Chief Operating Officer39.018.0Yes (X)$756,581$0$59,599
Stephen Leblanc
Chief Strategy Officer28.015.0Yes (X)$0$786,125$60,997
Susan A Reeves EDDRN
Executive VP (medical center)28.012.5Yes (X)$588,672$0$39,469
Jeffrey Obrien MHA
VP Clinical Operations28.012.0$394,484$0$65,285Yes (X)
Karen Clements RNBSNMSB
Chief Nursing Officer28.012.0$377,597$0$37,227Yes (X)
Simon Hillier
Dept. Chair - Anesthesiology28.012.0$0$622,587$61,932Yes (X)
Staci Hermann PHARMDMS
Chief Pharmacy Officer28.012.0$300,938$0$29,643Yes (X)
Curtis Lancaster
VP- Supply Chain40.00$329,993$0$63,500Yes (X)
David Gladstone MD
CHF CLNCL PHYSCN - RADIOLOGY28.012.0$380,284$0$58,544Yes (X)
Kimberly Troland JD
Deputy Gen Counsel28.012.0$435,801$0$43,015Yes (X)
Leigh Burgess
VP RESEARCH OPS40.00$414,617$0$49,911Yes (X)
Wendy Fielding MBA
FMR KEY EMP / VP FINANCE PLANNING28.013.5$311,443$0$61,876Yes (X)
Christine Schon MPA
FMR KEY EMP/ ADM VP PRMRY CARE0.040.5$0$373,374$53,981Yes (X)
GEORGE T BLIKE MD
Former/ Chief Quality & Value Officer21.010.5$0$400,007$50,140Yes (X)
Peter D Solberg MD
Former key/Chief Health Information Officer28.012.0$0$448,995$68,292Yes (X)
Richard I Rothstein MD
Former Dept. Chair / Service Line LDR - MED28.012.0$0$684,402$62,209Yes (X)
Sandra Wong MD
Former/SVP SVC LN & Chair of Surgery28.012.0$0$738,701$35,913Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,662,981TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$10,592,484TotReportableCompRltdOrgAmt
Total Other Compensation$1,754,029TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K729IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
Conifer Revenue Cycle Solutions LLC
1500 S Douglas Rd Ste 200AnanheimCA92806Revenue Management Services$36,964,101
CONSIGLI CONSTRUCTION CO INC
POBox 655025DallasTX752655025Construction Services$21,812,957
Harvey Construction
10 Harvey RdBedfordNH03110Construction$18,372,229
TRACE 3 LLC
4601 DTC BoulevardDenverCO80237Technology Services$10,903,858Suite 400
VIZIENT INC
290 E John Carpenter FwyIrvingTX75062Consulting Services$7,889,420
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K190CntrctRcvdGreaterThan100KCnt
Government Grants$53,275,630GovernmentGrantsAmt
All Other Contributions$3,064,256AllOtherContributionsAmt
Noncash Contributions$3,286,487NoncashContributionsAmt
Total Contributions$56,339,886TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE622110$1,275,865,372$1,270,064,549$5,800,823
RESEARCH RELATED ACTIVITIES622110$5,321,821$3,256,239$2,065,582
PHARMACY INCOME446110$199,612,159$169,007,883$30,604,276
NEAH & PROGRAM RELATED INVESTMENTS541900$2,054,573$720,222$1,334,351

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,482,853,925TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,939,087TotalRevenueColumnAmt
Unrelated Business Revenue-$405,530UnrelatedBusinessRevenueAmt
Exclusion$3,344,617ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$674,809RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$657,809RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$17,000RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,000TotalRevenueColumnAmt
Exclusion$17,000ExclusionAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA722514$2,011,065$2,011,065
All Other622110$62,603,441$62,603,441

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$64,614,506OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,606,764,404TotalRevenueColumnAmt
Related Or Exempt Func Income$1,505,652,334RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$39,399,502UnrelatedBusinessRevenueAmt
Exclusion$5,372,682ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$8,859,957TotalAmt
Program Services$8,859,957ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$590,336TotalAmt
Program Services$590,336ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$42,211TotalAmt
Program Services$42,211ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$8,954,807TotalAmt
Program Services$2,169,186ProgramServicesAmt
Management And General$6,630,718ManagementAndGeneralAmt
Fundraising$154,903FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$3,758,549TotalAmt
Program Services$1,390,581ProgramServicesAmt
Management And General$2,294,472ManagementAndGeneralAmt
Fundraising$73,496FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$666,737,989TotalAmt
Program Services$578,463,948ProgramServicesAmt
Management And General$88,274,041ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$49,979,781TotalAmt
Program Services$43,482,410ProgramServicesAmt
Management And General$6,497,371ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$76,195,535TotalAmt
Program Services$66,089,780ProgramServicesAmt
Management And General$10,105,755ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$43,294,015TotalAmt
Program Services$37,551,964ProgramServicesAmt
Management And General$5,727,498ManagementAndGeneralAmt
Fundraising$14,553FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,622,086TotalAmt
Management And General$1,622,086ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$777,873TotalAmt
Management And General$777,873ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$97,587,672TotalAmt
Program Services$79,049,837ProgramServicesAmt
Management And General$18,537,835ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,351,690TotalAmt
Program Services$48,896ProgramServicesAmt
Management And General$2,302,794ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$18,438,195TotalAmt
Program Services$13,650,535ProgramServicesAmt
Management And General$4,787,660ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$18,127,219TotalAmt
Program Services$1,812,722ProgramServicesAmt
Management And General$16,314,497ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$19,225,118TotalAmt
Program Services$1,501,409ProgramServicesAmt
Management And General$17,723,709ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,542,246TotalAmt
Program Services$853,652ProgramServicesAmt
Management And General$688,594ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$82,651TotalAmt
Program Services$81,682ProgramServicesAmt
Management And General$969ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$17,127,327TotalAmt
Program Services$1,712,733ProgramServicesAmt
Management And General$15,414,594ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$63,830,410TotalAmt
Program Services$22,527,442ProgramServicesAmt
Management And General$41,302,968ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$28,585,240TotalAmt
Program Services$7,511,607ProgramServicesAmt
Management And General$21,073,633ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$342,122,191$339,913,421$2,208,770
MEDICAID ENHANCEMENT TAX$57,311,611$57,311,611
EQUIPMENT RENTAL & MAINT$17,129,101$11,715,423$5,413,678
ACADEMIC, GME, TEACHING & EDUCATIONAL$6,515,319$5,133,800$1,381,519

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$10,755,527TotalAmt
Program Services$6,984,698ProgramServicesAmt
Management And General$3,770,829ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,561,544,656TotalAmt
Program Services$1,288,449,841ProgramServicesAmt
Management And General$272,851,863ManagementAndGeneralAmt
Fundraising$242,952FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$210,295,802BOYAmt
EOY$232,829,236EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$639,751BOYAmt
EOY$639,173EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$156,019,685BOYAmt
EOY$202,746,558EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$196,023BOYAmt
EOY$202,789EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$11,563,390BOYAmt
EOY$11,769,097EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$26,883,997BOYAmt
EOY$32,707,878EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$23,928,953BOYAmt
EOY$22,865,225EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,399,069,833LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$915,045,155LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$448,062,714BOYAmt
EOY$484,024,678EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$573,546,581BOYAmt
EOY$62,691,189EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$160,162,539BOYAmt
EOY$858,565,161EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$7,665,894BOYAmt
EOY$8,550,981EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$422,799,451BOYAmt
EOY$313,060,756EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,041,764,780BOYAmt
EOY$2,230,652,721EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$208,215,387BOYAmt
EOY$232,207,974EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$171,284,403BOYAmt
EOY$1,359,159EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$37,885,000BOYAmt
EOY$30,774,213EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$42,315,447BOYAmt
EOY$42,498,327EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$932,939,167BOYAmt
EOY$1,037,875,642EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,392,639,404BOYAmt
EOY$1,344,715,315EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$551,126,847BOYAmt
EOY$775,005,945EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$97,998,529BOYAmt
EOY$110,931,461EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$649,125,376BOYAmt
EOY$885,937,406EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,041,764,780BOYAmt
EOY$2,230,652,721EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$45,219,748ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$180,538,938NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$11,053,344OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementYes (true)PaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (true)DirectContactLegislatorsInd
Direct Contact Legislators$275,883DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$108,004OtherActivitiesAmt
Total Lobbying Expenditures$383,887TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYFormAndLineReferenceDesc
ExplanationLINES IB & 1G MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) EMPLOYS THREE FULL TIME STAFF WHOSE DUTIES INCLUDE LOBBYING. TYPICAL EXPENSES ASSOCIATED WITH THE LOBBYING ACTIVITIES INCLUDE STAFF SALARY, TRAVEL, MEMBERSHIP FEES AND DUES. FROM TIME TO TIME, MARY HITCHCOCK MEMORIAL HOSPITAL, THROUGH ITS EMPLOYEES AND THE USE OF CONSULTANTS, CONTACTS GOVERNMENT OFFICIALS AND LEGISLATORS. THIS CONTACT IS FOR THE PURPOSE OF PROPOSING LEGISLATION OR EXPRESSING AN OPINION ON CHANGES IN LEGISLATION THAT AFFECT MHMH AND ITS ABILITY TO CARRY OUT ITS MISSION. THE ACTIVITIES INCLUDE SENDING LETTERS TO, CALLING, AND MEETING WITH GOVERNMENT OFFICIALS AND LEGISLATORS. FOR THE FISCAL YEAR ENDED JUNE 30, 2021, MARY HITCHCOCK MEMORIAL HOSPITAL INCURRED $275,883 IN CONJUCTION WITH THESE ACTIVITIES. LINE 1I MHMH PAYS DUES TO VARIOUS ORGANIZATIONS RELATED TO ITS EXEMPT MISSION. THE AMOUNT REPORTED UNDER OTHER ACTIVITIES ON LINE 1I REFERS TO THE AMOUNT OF LOBBYING ACTIVITIES IDENTIFIED IN DUES PAYMENTS TO OUTSIDE ORGANIZATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$61,828,667BeginningYearBalanceAmt
Contributions$2,758,262ContributionsAmt
Investment Earnings Or Losses$10,467,971InvestmentEarningsOrLossesAmt
Other Expenditures$1,255,307OtherExpendituresAmt
End Year Balance$73,799,593EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$59,733,699BeginningYearBalanceAmt
Contributions$2,989,578ContributionsAmt
Investment Earnings Or Losses$698,013InvestmentEarningsOrLossesAmt
Other Expenditures$1,592,623OtherExpendituresAmt
End Year Balance$61,828,667EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$58,012,839BeginningYearBalanceAmt
Contributions$1,209,274ContributionsAmt
Investment Earnings Or Losses$1,592,942InvestmentEarningsOrLossesAmt
Other Expenditures$1,081,356OtherExpendituresAmt
End Year Balance$59,733,699EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$56,795,299BeginningYearBalanceAmt
Contributions$338,335ContributionsAmt
Investment Earnings Or Losses$2,065,129InvestmentEarningsOrLossesAmt
Other Expenditures$1,185,924OtherExpendituresAmt
End Year Balance$58,012,839EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,754,800BeginningYearBalanceAmt
Contributions$137,888ContributionsAmt
Investment Earnings Or Losses$2,553,792InvestmentEarningsOrLossesAmt
Other Expenditures$651,181OtherExpendituresAmt
End Year Balance$56,795,299EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.2277BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.5047PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.2676TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$54,364,941OtherCostOrOtherBasisAmt
Book Value$54,364,941BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$645,697,230OtherCostOrOtherBasisAmt
Depreciation$400,280,478DepreciationAmt
Book Value$245,416,752BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,111,615OtherCostOrOtherBasisAmt
Depreciation$3,985,045DepreciationAmt
Book Value$126,570BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$615,047,871OtherCostOrOtherBasisAmt
Depreciation$510,779,632DepreciationAmt
Book Value$104,268,239BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$79,848,176OtherCostOrOtherBasisAmt
Book Value$79,848,176BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$484,024,678TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
PRIVATE EQUITIES$8,134F
HEDGE FUNDS
OTHER INVESTMENTS
INVESTMENT IN POOLED FUNDS (MIP)$858,557,027F
FieldValueIRS element (for citing)
Total Book Value Securities$858,565,161TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (9 entries)

DescDescBook ValueBookValueAmt
INVESTMENT IN CAPTIVE$23,302,973
DUE FROM AFFILIATES$245,735,268
CAPITAL LEASE RECEIVABLE$36,951,437
OTHER MISC ASSETS
UNAMORTIZED BOND ISSUANCE COSTS$464,213
OTHER INVESTMENT ASSETS$490,726
INVESTMENT IN MIP
457B PLAN ASSETS$3,304,082
OTHER RECEIVABLES$2,812,057
FieldValueIRS element (for citing)
Total Book Value Other Assets$313,060,756TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
THIRD PARTY RESERVES$163,493,812
ACCRUED POST RETMNT PENS & MED$62,818,453
Payable to Dartmouth Hitchcock Health$811,563,377
FieldValueIRS element (for citing)
Total Liability$1,037,875,642TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part X, Line 2 ASC 740 (FIN 48) FOOTNOTENO ASC 740 (FIN 48) FOOTNOTE WAS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS AS THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT OR SINCE ADOPTION.
Schedule D, Part V, Line 4 Intended uses of endowment fundsTHE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROMOTE AND ADVANCE THE FOLLOWING MISSION-RELATED PROGRAMS: HEALTHCARE SERVICES, RESEARCH, CHARITY CARE, COMMUNITY OUTREACH AND ADVOCACY, EQUIPMENT PURCHASES, AND HEALTH EDUCATION.

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxtOfficesOfficesCntEmployeeEmployeeCntType Of Activities ConductedTypeOfActivitiesConductedTxtRegion Total ExpendituresRegionTotalExpendituresAmt
Central America and the Caribbean00,Grants to recipients located in the region$42,211
Central America and the Caribbean00Investments$22,432,583
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continuation Total Office0ContinuationTotalOfficeCnt
Continuation Total Employee0ContinuationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$22,474,794SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$22,474,794TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegionTxt
Purpose Of GrantPROGRAM SUPPORTPurposeOfGrantTxt
Cash Grant$42,211CashGrantAmt
Manner Of Cash DisbursementCASHMannerOfCashDisbursementTxt
Valuation Method UsedFMVValuationMethodUsedDesc
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt
Transfer To Foreign CorpYes (true)TransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipYes (true)ForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipYes (true)ForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule F, Part I, Line 2 Procedures for monitoring use of grant fundsTHE HOSPITAL PROVIDES UNRESTRICTED PROGRAM SUPPORT FOR CERTAIN FOREIGN ORGANIZATIONS CHOSEN AND DIRECTED BY THE PHYSICIANS AND/OR RESEARCHERS WORKING DIRECTLY WITH THE CHARITY.
Schedule F, Part I, Line 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDSTHE HOSPITAL PROVIDES UNRESTRICTED PROGRAM SUPPORT FOR CERTAIN FOREIGN ORGANIZATIONS CHOSEN AND DIRECTED BY THE PHYSICIANS AND/OR RESEARCHERS WORKING DIRECTLY WITH THE CHARITY.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other225FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,373,173TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,373,173NetCommunityBenefitExpnsAmt
Total Expense0.0041TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$270,606,141TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$131,640,820DirectOffsettingRevenueAmt
Net Community Benefit Expns$138,965,321NetCommunityBenefitExpnsAmt
Total Expense0.0904TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$276,979,314TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$131,640,820DirectOffsettingRevenueAmt
Net Community Benefit Expns$145,338,494NetCommunityBenefitExpnsAmt
Total Expense0.0946TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,964,373TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,179,117DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,785,256NetCommunityBenefitExpnsAmt
Total Expense0.0051TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$54,424,574TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,908,285DirectOffsettingRevenueAmt
Net Community Benefit Expns$39,516,289NetCommunityBenefitExpnsAmt
Total Expense0.0257TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,460,983TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,190,167DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,270,816NetCommunityBenefitExpnsAmt
Total Expense0.0028TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,960,537TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,535,864DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,424,673NetCommunityBenefitExpnsAmt
Total Expense0.0022TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,020,436TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,020,436NetCommunityBenefitExpnsAmt
Total Expense0.0020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$124,830,903TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$66,813,433DirectOffsettingRevenueAmt
Net Community Benefit Expns$58,017,470NetCommunityBenefitExpnsAmt
Total Expense0.0378TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$401,810,217TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$198,454,253DirectOffsettingRevenueAmt
Net Community Benefit Expns$203,355,964NetCommunityBenefitExpnsAmt
Total Expense0.1323TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,750TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$17,750NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,551,510TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$967,237DirectOffsettingRevenueAmt
Net Community Benefit Expns$584,273NetCommunityBenefitExpnsAmt
Total Expense0.0004TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,945,492TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,651,746DirectOffsettingRevenueAmt
Net Community Benefit Expns$293,746NetCommunityBenefitExpnsAmt
Total Expense0.0002TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$3,514,752TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,618,983DirectOffsettingRevenueAmt
Net Community Benefit Expns$895,769NetCommunityBenefitExpnsAmt
Total Expense0.0006TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Reimbursed By Medicare$353,165,382ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$381,019,903CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$27,854,521MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARY HITCHCOCK MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE MEDICAL CENTER DRIVEAddressLine1Txt
CityLEBANONCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.DARTMOUTH-HITCHCOCK.ORGWebsiteAddressTxt
State License01799StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Childrens HospitalYes (X)ChildrensHospitalInd
Teaching HospitalYes (X)TeachingHospitalInd
Research FacilityYes (X)ResearchFacilityInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPSYCHIATRIC UNIT AND TRANSPLANT UNIT CANCER CENTEROtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MARY HITCHCOCK MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.dartmouth-hitchcock.org/about/community-healthOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.dartmouth-hitchcock.org/sites/default/files/2021-01/dh-fy20-22-CHIP-010220.pdfStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care225.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.0FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.dartmouth-hitchcock.org/patients-visitors/financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.dartmouth-hitchcock.org/patients-visitors/financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.dartmouth-hitchcock.org/patients-visitors/financial-assistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) AND DARTMOUTH-HITCHCOCK CLINIC (DHC, COLLECTIVELY KNOWN AS D-H) ARE ACTIVELY ENGAGED IN THE DEVELOPMENT OF THE UPPER VALLEY REGIONAL PUBLIC HEALTH ADVISORY COUNCIL AND GREATER SULLIVAN COUNTY PUBLIC HEALTH ADVISORY COUNCIL (WITH 60+ COMMUNITY REPRESENTATIVES). MEMBERS OF THESE TWO COMMUNITY HEALTH ADVISORY GROUPS HAVE HAD THE OPPORTUNITY TO REVIEW AND COMMENT ON DRAFTS OF DARTMOUTH-HITCHCOCK'S COMMUNITY HEALTH IMPROVEMENT PLAN. THE PLAN DOCUMENT HAS ALSO BEEN CIRCULATED TO PUBLIC HEALTH OFFICIALS IN NEW HAMPSHIRE AND VERMONT FOR THEIR COMMENT. IN ADDITION, DARTMOUTH-HITCHCOCK REPRESENTATIVES SERVE ON NUMEROUS BOARDS, TASK FORCES, MUNICIPAL HEALTH LEADERSHIP AND PLANNING TEAMS, AND OTHER COMMUNITY HEALTH LEADERSHIP ENTITIES IN ORDER TO ENSURE THAT BOTH ORGANIZATIONS PARTICIPATE IN AND BETTER-UNDERSTAND THE NEEDS OF OUR COMMUNITY. MHMH CONTRACTED WITH JOHN SNOW RESEARCH AND TRAINING INSTITUTE/COMMUNITY HEALTH INSTITUTE TO PROVIDE CONSULTATION AND TECHNICAL EXPERTISE TO OUR ASSESSMENT PROCESS. JOHN SNOW RESEARCH AND TRAINING INSTITUTE IS A PUBLIC HEALTH MANAGEMENT CONSULTING AND RESEARCH ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF INDIVIDUALS AND COMMUNITIES THROUGHOUT THE WORLD. DURING THE PERIOD MARCH THROUGH AUGUST 2018, A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY DARTMOUTH-HITCHCOCK AND ALICE PECK DAY MEMORIAL HOSPITAL IN PARTNERSHIP WITH NEW LONDON HOSPITAL, VALLEY REGIONAL HOSPITAL, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER, AND VISITING NURSE & HOSPICE OF VT/NH. THE PURPOSE OF THE ASSESSMENT WAS TO IDENTIFY COMMUNITY HEALTH CONCERNS, PRIORITIES, AND OPPORTUNITIES FOR COMMUNITY HEALTH AND HEALTH CARE DELIVERY SYSTEMS IMPROVEMENT. WHILE DARTMOUTH-HITCHCOCK MEDICAL CENTER SERVES AS A TERTIARY REFERRAL MEDICAL CENTER FOR A LARGE, MULTI-STATE AREA, THE GEOGRAPHIC AREA OF INTEREST FOR THE PURPOSES OF THIS ASSESSMENT WAS THE PRIMARY SERVICE AREA OF MARY HITCHCOCK MEMORIAL HOSPITAL REGIONAL HOSPITAL, MT. ASCUTNEY HOSPITAL AND HEALTH CENTER, AND VISITING NURSE & HOSPICE OF VT/NH. THE PURPOSE OF THE ASSESSMENT WAS TO IDENTIFY COMMUNITY HEALTH CONCERNS, PRIORITIES, AND OPPORTUNITIES FOR COMMUNITY HEALTH AND HEALTH CARE DELIVERY SYSTEMS IMPROVEMENT. WHILE DARTMOUTH-HITCHCOCK MEDICAL CENTER SERVES AS A TERTIARY REFERRAL MEDICAL CENTER FOR A LARGE, MULTI-STATE AREA, THE GEOGRAPHIC AREA OF INTEREST FOR THE PURPOSES OF THIS ASSESSMENT WAS THE PRIMARY SERVICE AREA OF MARY HITCHCOCK MEMORIAL HOSPITAL AND ALICE PECK DAY MEMORIAL HOSPITAL. THIS PRIMARY SERVICE AREA WAS DEFINED AS 19 MUNICIPALITIES COMPRISING THE UPPER VALLEY OF NEW HAMPSHIRE AND VERMONT WITH A TOTAL RESIDENT POPULATION OF APPROXIMATELY 70,000 PEOPLE. METHODS EMPLOYED IN THE ASSESSMENT INCLUDED A SURVEY OF AREA RESIDENTS MADE AVAILABLE THROUGH DIRECT MAIL AND WEBSITE LINKS, A SURVEY OF KEY COMMUNITY STAKEHOLDERS WHO ARE AGENCY, MUNICIPAL OR COMMUNITY LEADERS, A SERIES OF COMMUNITY DISCUSSION GROUPS CONVENED IN THE PRIMARY SERVICE AREA, AND A REVIEW OF AVAILABLE POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS. IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), POPULATIONS EXPERIENCING HEALTH DISPARITIES OR VULNERABLE TO POOR HEALTH OUTCOMES ARE PRIMARILY DEFINED AS THOSE POPULATIONS FACING SIGNIFICANT INCOME AND SOCIAL DETERMINANTS CHALLENGES, WHICH IN THIS REGION ARE MORE STRONGLY ASSOCIATED WITH NEGATIVE IMPACTS ON HEALTH THAN RACE OR ETHNICITY. ENHANCED EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THESE POPULATIONS THROUGH TARGETED SURVEYS AND COMMUNITY CONVERSATIONS, INCLUDING FACILITATED SURVEYS AND DISCUSSIONS AT COMMUNITY SUPPERS, A REGIONAL FREE CLINIC, HOMELESS PROGRAMS, AND OTHER COMMUNITY SETTINGS SERVING ECONOMICALLY-VULNERABLE RESIDENTS. IN ADDITION, WE CONVENED A FOCUS GROUP OF BLACK AND AFRICAN-AMERICAN COMMUNITY MEMBERS. FINDINGS OF THIS ASSESSMENT HAVE BEEN SHARED WITH PUBLIC HEALTH OFFICIALS IN NH AND VT, AS WELL AS WITH THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY. DURING THIS ASSESSMENT, MARY HITCHCOCK MEMORIAL HOSPITAL USED SURVEYS FROM MARCH 2018 THROUGH AUGUST 2018 TO GENERATE INPUT FROM 2,100 RESIDENTS. SURVEYS WERE MADE AVAILABLE THROUGH PRIMARY CARE CLINICS, FREE CARE CLINICS, A SHELTER FOR THE HOMELESS, A FREE COMMUNITY DINNER, ANNUAL TOWN MEETINGS/ELECTIONS, AND NUMEROUS OTHER COMMUNITY LOCATIONS. VISITING NURSES AND OTHERS PROVIDED PRE-PAID MAILERS AND SURVEYS TO HOMEBOUND RESIDENTS. RESIDENTS COMPLETING SURVEYS INCLUDED MEMBERS OF AFRICAN-AMERICAN, HISPANIC, NATIVE AMERICAN, AND ASIAN POPULATIONS. SURVEYS WERE DISTRIBUTED THROUGH REGIONAL HEALTH CLINICS, THE REGION'S SHELTER FOR HOMELESS POPULATIONS; THE REGION'S LOW-INCOME HOUSING TRUST; SENIOR CENTERS; SUBSTANCE USE DISORDER TREATMENT PROGRAMS, DELIVERED DIRECTLY TO RESIDENT HOMES, AND OTHER LOCATIONS WHERE POPULATIONS MOST AFFECTED BY HEALTH DISPARITIES CONGREGATE. MARY HITCHCOCK MEMORIAL HOSPITAL DISSEMINATED THE SURVEY TOGETHER WITH MULTIPLE COMMUNITY ORGANIZATIONS THAT SERVE LOW-INCOME, FRAIL, AND HEALTH DISPARITY POPULATIONS. COMMUNITY PARTNERS, PROVIDED ASSISTANCE DISSEMINATING THE SURVEY, INCLUDING THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY, WHOSE MEMBERSHIP INCLUDES COMMUNITY MENTAL HEALTH SERVICES, SUBSTANCE USE SERVICES, MENTAL HEALTH PEER LEADERS, WIC PROVIDERS, SENIOR SERVICES ADVOCATES, SERVICES WORKING WITH PEOPLE WITH PHYSICAL AND DEVELOPMENTAL DISABILITIES, COMMUNITY NURSING, VISITING NURSES, AND OTHER CORE HUMAN SERVICES. IN ADDITION TO ASSISTING IN SURVEY DISSEMINATION, THESE PROVIDERS ADVOCATED FOR UNDERSERVED AND VULNERABLE POPULATIONS IN OUR REGION AS A PART OF THE CHNA PROCESS. DURING THIS CHNA PROCESS, OUR CHNA COLLABORATIVE TEAM CONVENED ONE REGIONAL DISCUSSION GROUP OF PERSONS IDENTIFYING AS BLACK/AFRICAN-AMERICAN (MAY 10, 2018); WE MADE RESIDENT SURVEYS WIDELY AVAILABLE TO COMMUNITY RESIDENTS THROUGH PUBLIC LIST SERVES, DIRECT E-MAIL INVITATIONS TO PATIENTS OF OUR PRIMARY CARE CLINICS, SURVEY LINKS ON TOWN WEB SITES AND E-NEWS, EMPLOYEE E-NEWS IN MAJOR EMPLOYERS, AND THROUGH OTHER SYSTEMS THAT PROVIDED WIDESPREAD ACCESS TO OUR SURVEYS. WE ALSO REVIEWED MEETING MINUTES FROM TWO REGIONAL COMMUNITIES (HARTFORD, VT, AND CLAREMONT, NH), WHERE ISSUES OF RACIAL EQUITY AND RACISM HAVE BEEN EXPLORED AT TOWN AND SCHOOL GOVERNANCE LEVELS. WE PARTNERED CLOSELY WITH ORGANIZATIONS SERVING POPULATIONS AFFECTED BY POVERTY, LACK OF INSURANCE, HOMELESSNESS, BEHAVIORAL HEALTH CONDITIONS, AND SERIOUS AND CHRONIC ILLNESSES IN ORDER TO SURVEY THESE MEMBERS OF POPULATIONS IN OUR COMMUNITY, AND HOSTED MULTIPLE DISCUSSION GROUPS WITH PEOPLE AFFECTED BY POVERTY AND CHRONIC ILLNESS. WE RECOGNIZE THE LIMITATIONS OF OUR ENGAGEMENT OF RACIAL AND ETHNIC MINORITY MEMBERS OF OUR COMMUNITY, AND ARE WORKING TO IMPROVE THIS PART OF OUR CHNA PROCESS. OUR MINORITY POPULATION IS QUITE SMALL: 0.9% OF THE POPULATION OF GRAFTON COUNTY, NH IDENTIFIES AS AFRICAN AMERICAN, 0.4% AS NATIVE AMERICAN, 1.8% AS HISPANIC/LATINO, 3.0% AS ASIAN. 92.1% OF THE MHMH HOSPITAL SERVICE AREA'S RESIDENTS IDENTIFY AS CAUCASIAN. WIDE DISPERSAL OF THIS POPULATION ACROSS A LARGE GEOGRAPHY FURTHER COMPLICATES ENGAGEMENT EFFORTS. OUR SUMMER 2018 DISCUSSION GROUP WITH COMMUNITY MEMBERS IDENTIFYING AS BLACK/AFRICAN AMERICAN WAS A POSITIVE, BUT LIMITED IMPROVEMENT OVER PRIOR YEARS. HOUSEHOLD MEDIAN INCOME, INSURANCE STATUS, AND OTHER INDICATORS OF POVERTY ARE SIGNIFICANT DRIVERS OF DISPARITY IN OUR REGION. POVERTY RATES RANGE WIDELY BY TOWN, WITH A RANGE BY TOWN OF 2.9% TO 31.7% OF HOUSEHOLDS LIVING ON INCOMES BELOW 200% OF FEDERAL POVERTY LEVEL. THESE POPULATIONS FACE NOTABLE HEALTH DISPARITY CONDITIONS ASSOCIATED WITH POVERTY AND OTHER SOCIAL DETERMINANTS OF HEALTH NEEDS. (CONTINUED PART vi)
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. DURING MARCH 2018 - JUNE 2019, MHMH PARTNERED WITH ALICE PECK DAY MEMORIAL HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT. WE ALSO PARTNERED WITH NEIGHBORING HOSPITALS AND ORGANIZATIONS INCLUDING VALLEY REGIONAL HOSPITAL, NEW LONDON HOSPITAL, MOUNT ASCUTNEY HOSPITAL AND HEALTH CENTER, AND VISITING NURSE & HOSPICE OF VT/NH. USING SIMILAR COMMUNITY HEALTH NEEDS ASSESSMENT TOOLS AND APPROACHES, ALLOWING US TO COMPARE COMMUNITY HEALTH NEEDS ACROSS A BROAD GEOGRAPHIC, MULTI-HOSPITAL REGION.
Schedule H, Part V, Section B, Line 6b Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. DURING MARCH 2018- JUNE 2019, IN ADDITION TO WORKING WITH DARTMOUTH-HITCHCOCK CLINIC, MHMH WORKED CLOSELY WITH THE MEMBER ORGANIZATIONS OF THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY (60+ MEMBER ORGANIZATIONS) AND GREATER SULLIVAN COUNTY PUBLIC HEALTH ADVISORY COUNCIL TO DISSEMINATE SURVEYS, SERVE AS KEY INFORMANTS, AND TO PROVIDE OVERALL REVIEW AND FEEDBACK RE: FINDINGS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT
Schedule H, Part V, Section B, Line 7 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. THE NEEDS ASSESSMENT WAS DISTRIBUTED TO NON-PROFIT ORGANIZATIONS THROUGHOUT THE REGION INCLUDING THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY, WHICH IS A MEMBERSHIP GROUP OF REIGONAL NON-PROFIT, MUNICIPAL, SAFETY, HUMAN SERVICE, AND PUBLIC HEALTH ORGANIZATIONS. IT IS ALSO AVAILABLE FROM THE ORGANIZATION UPON REQUEST AND IS POSTED ON THE MHMH WEB PAGE.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MHMH IS INCREASING COMMUNITY BENEFITS SPENDING TO ADDRESS IDENTIFIED COMMUNITY NEEDS BASED ON THE MOST RECENT CHNA IN AREAS OF TRAUMA AND VIOLENCE, SOCIAL DETERMINANTS OF HEALTH, IMPROVING ACCESS TO HEALTH CARE, AND NEEDS OF OLDER ADULTS, AS WELL AS MAINTAINING ONGOING INVESTMENTS IN BEHAVIORAL HEALTH AND SUBSTANCE USE NEEDS, STRENGTHENING FAMILIES AND CHILDREN, AND CANCER CARE AND TREATMENT. IN FY 2020, MARY HITCHCOCK MEMORIAL HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT STRATEGIES WERE CONSISTENT WITH THE INTENTIONS IDENTIFIED IN OUR FY2016 AND FY2019 COMMUNITY HEALTH IMPROVEMENT PLANS. AREAS WERE ANALYZED AND MHMH RESPONDED BY INCREASING INVESTMENTS, MAINTAINING SIMILAR LEVELS OF INVESTMENTS FOR SERVICES AND INITIATIVES, OR LIMITING INVESTMENT IN AREAS WHERE OTHER COMMUNITY ORGANIZATIONS ALREADY PROVIDE LEADERSHIP AND SERVICES TO ADDRESS THE NEED, AND/OR WHERE THE IDENTIFIED NEED IS SIGNIFICANTLY OUTSIDE THE MISSION/SERVICES/SCOPE OF MHMH. MARY HITCHCOCK MEMORIAL HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN IS A 3-YEAR DOCUMENT IDENTIFYING ANTICIPATED INVESTMENTS AND ACTIVITIES THAT IT WILL TAKE TO ADDRESS NEEDS IDENTIFIED IN THE MOST RECENT UPPER VALLEY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). WITH THE ONSET OF COVID-19 IN FEBRUARY-MARCH 2020, MHMH HAS ADDED AND PRIORITIZED COVID-19 DRIVEN COMMUNITY NEEDS TO OUR OTHER CHNA PRIORITIES. THIS HAS INCLUDED PROVIDING SIGNIFICANT FUNDING AND STAFF SUPPORT TO HELP COMMUNITY FOOD SUPPORT PROGRAMS, BEHAVIORAL HEALTH PROVIDERS, NURSING HOMES, AND OTHER COMMUNITY ORGANIZATIONS ADAPT TO AND MAINTAIN BASIC SOCIAL SERVICES SAFELY DURING THE PANDEMIC.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - MARY HTCHCOCK MEMORIAL HOSPITAL. PATIENTS WHOSE FAMILY INCOME EXCEEDS 300% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF MHMH.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. MHMH HAS A SEPARATE UNINSURED DISCOUNT POLICY THAT OUTLINES HOW THE DISCOUNT IS CALCULATED ANNUALLY AND IS APPLIED PRIOR TO BILLING ANY UNINSURED PATIENT. THIS ASSURES A PATIENT IS NOT BILLED AT AN AMOUNT GREATER THAN THE AMOUNT GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS POLICY IS REFERENCED IN THE FINANCIAL ASSISTANCE POLICY.
Schedule H, Part V, Section B, Line 16 Facility , 1Facility , 1 - MARY HITCHCOCK MEMORIAL HOSPITAL. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON MHMH'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. MHMH PROVIDES THE PLAIN-LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. MHMH CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, MHMH POSTS INFORMATION ABOUT THE POLICY IN PUBLIC AREAS THROUGHOUT THE FACILITIES INCLUDING ADMISSION OFFICES, PUBLIC AREA BOARDS THROUGHOUT THE FACILITIES, THE EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE POLICY BROCHURES IN PATIENT AREAS. MHMH SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, MHMH CHECKS ALL STATE AND FEDERAL PROGRAMS TO SEE IF INDIVIDUALS ARE ELIGIBLE FOR ASSISTANCE. PATIENTS ARE ALSO SCREENED TO DETERMINE QUALIFICATION FOR FINANCIAL ASSISTANCE AND THE APPLICATION IS PROVIDED AND/OR COMPLETED AT THIS TIME.
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (22 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part VI, Line 2 FACILITY INFORMATIONTHE HOSPITAL HAS A SECOND CANCER TREATMENT CENTER LOCATED IN SAINT JOHNSBURY, VERMONT. THIS LOCATION IS REGISTERED UNDER THE SAME LICENSE AS THE ORGANIZATION'S MAIN CAMPUS LOCATED IN LEBANON, NEW HAMPSHIRE.
Schedule H, Part I, Line 3c OTHER FACTORS USED IN DETERMINING ELIGIBILITY OTHER THAN FPGMHMH USES THE FPG GUIDELINES IN DETERMINING THE INITIAL LEVEL OF FINANCIAL ASSISTANCE PROVIDED. IN ADDITION, MHMH ALLOWS FOR CATASTROPHIC ASSISTANCE CONSIDERATION BASED ON A CALCULATION OF 10% OF TWO YEARS INCOME PLUS 10% OF AMOUNT OVER SHELTERED ASSETS. IF THE PROJECTED OR CURRENT SELF-PAY BALANCE IS GREATER THAN THIS CALCULATION, THE SELF-PAY BALANCE IS REDUCED TO THE SUM OF 10% OF TWO YEARS INCOME PLUS 10% OF ASSETS. EACH HOUSEHOLD IS ALLOWED CERTAIN SHELTERED ASSETS WHICH ARE NOT USED WHEN CALCULATING HOUSEHOLD INCOME OR ASSETS SAVINGS IS SHELTERED UP TO 100% OF FPL BASED ON FAMILY SIZE, EQUITY IN PRIMARY RESIDENCE UP TO $200,000 UP TO 55 AND $250,000 FOR AGED 55 AND OLDER, AND A RETIREMENT SHELTER OF UP TO $100,000 IN RETIREMENT ASSETS AS LONG AS IT IS EMPLOYER BASED CONTRIBUTIONS IF WORKING OR IRA IF SELF-EMPLOYED. IF A PATIENT IS RETIRED, PRIOR RETIREMENT ACCOUNTS WOULD BE INCLUDED AS A SHELTERED ASSET.
Schedule H, Part I, Line 6a COMMUNITY BENEFITS REPORTMARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC (COLLECTIVELY REFERRED TO AS DARTMOUTH-HITCHCOCK (D-H)) SHARE COMMON BOARD MEMBERS AND OPERATE UNDER AN AFFILIATION AGREEMENT. D-H PERFORMS A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND FILES A CONSOLIDATED COMMUNITY BENEFITS REPORT WITH THE STATE OF NEW HAMPSHIRE. FOR PURPOSES OF IRS FORM 990, SCHEDULE H, ONLY MHMH HOSPITAL NUMBERS WERE USED. ALL AMOUNTS RELATING TO DHC WERE EXCLUDED. THE NEW HAMPSHIRE COMMUNITY BENEFITS REPORT FILED FOR FISCAL YEAR 2021, DHC AND MHMH COMBINED, TOTALED $256,682,615.
Schedule H, Part V, Section B, Line 5 PERSONS WHO REPRESENT BROAD INTERESTS OF COMMUNITY SERVED CONTDURING OUR ASSESSMENT PROCESS, MHMH MADE SPECIFIC EFFORTS TO CONTACT AND RECEIVE INPUT FROM MEMBERS OF INCOME-VULNERABLE POPULATIONS, INCLUDING: * A DISCUSSION GROUP WITH PREGNANT AND PARENTING TEENS PARTICIPATING IN AN ALTERNATIVE HIGH SCHOOL ENVIRONMENT AT THE FAMILY PLACE PARENT CHILD CENTER (MAY 1, 2018). * A DISCUSSION GROUP WITH ADULTS LIVING WITH DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES/CAREGIVERS (MAY 4TH, 2018). * A DISCUSSION GROUP WITH PREGNANT WOMEN IN TREATMENT FOR SUBSTANCE USE DISORDERS (APRIL 9, 2018). * A DISCUSSION GROUP WITH COMMUNITY NURSES SERVING CHRONICALLY ILL, HOMEBOUND, AND OTHERWISE VULNERABLE OLDER ADULTS IN REGIONAL TOWNS (MAY 8, 2018). * A DISCUSSION GROUP WITH THE BOARD AND LEADERSHIP OF THE MASCOMA COMMUNITY HEALTH CLINIC, A COMMUNITY HEALTH CLINIC SEEKING FEDERALLY QUALIFIED HEALTH CENTER LOOK-ALIKE STATUS AND SERVING A SET OF COMMUNITIES WITH HEALTH DISPARITIES (MAY 14, 2018) * WORKING WITH THE GOOD NEIGHBOR HEALTH CLINIC AND MASCOMA COMMUNITY HEALTH CENTER TO DISSEMINATE SURVEYS TO PATIENTS WHO ARE UNINSURED AND LOW-INCOME. DISSEMINATING SURVEYS AT THE HAVEN (SHELTER); LISTEN COMMUNITY SERVICES (BASIC NEED SUPPORT, FOOD SHELF, AND COMMUNITY DINNERS); TO PARENTS OF CHILDREN IN DARTMOUTH-HITCHCOCK AND ALICE PECK DAY'S PEDIATRICS CLINICS; VIA WOMEN, INFANTS, AND CHILDREN'S CLINICS; THROUGH GRAFTON COUNTY SENIOR CITIZENS COUNCIL (HOME-DELIVERED MEALS AND CONGREGATE MEALS); THROUGH VISITING NURSE AND HOSPICE OF VT AND NH (HOME-VISITING PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FOR SENIORS WITH COMPLEX HEALTH NEEDS); AND THROUGH OTHER COMMUNITY ORGANIZATIONS SERVING PEOPLE AFFECTED BY POVERTY AND POOR HEALTH. IN FY21 MHMH STAFF WORKED CLOSELY WITH UPPER VALLEY STRONG AND GREATER SULLIVAN STRONG, RAPID-FORMING COMMUNITY RESPONSE COALITIONS EACH WITH 50+ COMMUNITY ORGANIZATION MEMBERS, TO SHARE INFORMATION ABOUT REAL TIME IMPACTS OF COVID-19, INCLUDING SHARING INFORMATION ABOUT PREVENTION, RISK REDUCTION, VACCINATIONS, AND IMPACT OF COVID-19 ON COMMUNITY SOCIAL SAFETY NEW ORGANIZATIONS, HELPING TO COORDINATE COMMUNITY RESPONSE AND KEEP CRITICAL COMMUNITY SERVICES OPEN AND FUNCTIONING DESPITE COVID-19 RELATED COMMUNITY DISRUPTIONS.
Schedule H, Part I, Line 7g Subsidized Health ServicesThe organization did not include any subsidized health service costs attributable to a physician clinic on part I, line 7G.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation24979434
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe costing methodology used to calculate the amounts reported was a cost-to-charge ratio derived from worksheet 2, ratio of patient care to cost-to-charges.
Schedule H, Part II Community Building ActivitiesCommunity building activities include expenses related to coalitions such as ones that address regional public health networks, improvement in systems of care for substance use and mental health disorders, prevention of substance abuse, falls reduction for older adults, and prescription drug misuse.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountBASED ON ACCOUNTING GUIDANCE, BAD DEBT IS RECORDED AS A REDUCTION TO NET PATIENT REVENUE.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyThe hospital is unable to estimate accurately the amount of bad debt expense attributable to patients eligible for financial assistance. Although a portion of bad debt expense may be related to patients who would qualify for charity care, a reportable figure cannot be reasonably estimated.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteMHMH FILES A CONSOLIDATED AUDITED FINANCIAL STATEMENT WITH DARTMOUTH-HITCHCOCK CLINIC AND OTHER SUBSIDIARIES. MHMH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR FINANCIAL ASSISTANCE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE MHMH DOES NOT ANTICIPATE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. MHMH GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS. MOST ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY ARRANGEMENTS. FOR FINANCIAL STATEMENT PURPOSES, Dartmouth Hitchcock Health HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsThe costing methodology used to calculate the amounts reported as Medicare shortfalls was derived from the Internal Revenue Service's Worksheet B as provided for Part III calculations. MHMH had revenues of $-91,956,503 and costs of $124,404,547 for services not included on the Medicare Cost Report (Ambulance Services, Laboratory and other fee screens, and Medicare Part C & D services) MHMH incurred a net loss of $32,448,044 on the provision of these services. Because of the central role of the organization in serving the healthcare needs of its community and the demographic characteristics of the community served, it is likely that a portion of the medicare shortfall should be considered community benefit expenditure. MHMH has not identified a specific amount of medicare shortfall that should be reported as such.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceMHMH HAS A CREDIT AND COLLECTION POLICY THAT ADDRESSES THE PROCEDURES FOR PATIENTS WHO QUALIFY FOR REDUCED-COST CARE. THE POLICY PROHIBITS USING EXTRAORDINARY COLLECTION PRACTICES OR PLACING AMOUNTS WITH COLLECTION AGENCIES. IF A FINANCIAL ASSISTANCE POLICY ELIGIBLE PATIENT HAS A BALANCE FOR WHICH THEY ARE RESPONSIBLE AFTER A FINANCIAL ASSISTANCE DISCOUNT IS APPLIED, THE STANDARD PRACTICES ARE FOLLOWED AS OUTLINED IN THE D-H CREDIT AND COLLECTIONS POLICY.
Schedule H, Part V, Section B, Line 16a FAP website- MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16a URL: https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website- MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16b URL: https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- MARY HITCHCOCK MEMORIAL HOSPITAL: Line 16c URL: https://www.dartmouth-hitchcock.org/patients-visitors/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessmentMARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH HITCHCOCK CLINIC (COLLECTIVELY REFERRED TO AS DARTMOUTH-HITCHCOCK (D-H)) SHARE COMMON BOARD MEMBERS AND OPERATE UNDER AN AFFILIATION AGREEMENT. D-H PERFORMS A JOINT COMMUNITY NEEDS ASSESSMENT AND FILES A CONSOLIDATED COMMUNITY BENEFITS REPORT. DARTMOUTH-HITCHCOCK PARTICIPATES WITH OTHER HEALTH CARE CHARITABLE TRUSTS AND COMMUNITY PARTNERS IN EACH OF OUR SERVICE AREAS TO COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENTS. DURING FY2020, MHMH PARTNERED WITH ALICE PECK DAY MEMORIAL HOSPITAL, TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. WE ALSO WORKED TOGETHER WITH NEIGHBORING HOSPITALS, INCLUDING MOUNT ASCUTNEY HOSPITAL AND HEALTH CARE, VALLEY REGIONAL HOSPITAL, NEW LONDON HOSPITAL , AND VISITING NURSE & HOSPICE OF VT & NH TO USE SIMILAR COMMUNITY HEALTH NEEDS ASSESSMENTS TOOLS AND APPROACH, TO ALLOW COMPARABILITY OF HEALTH DATA ACROSS A WIDER GEOGRAPHIC REGION. COLLECTIVELY D-H AND PARTNERED HOSPITALS HIRED COMMUNITY HEALTH INSTITUTE/JOHN SNOW RESEARCH AND TRAINING INSTITUTE, A PUBLIC HEALTH CONSULTING FIRM, TO PROVIDE TECHNICAL ASSISTANCE AND ANALYSIS RELATED TO OUR COMMUNITY HEALTH NEEDS ASSESSMENTS. THE NEEDS ASSESSMENT INCLUDED REVIEWING SELECTED SERVICE AREA DEMOGRAPHICS; PUBLIC HEALTH DATA AVAILABLE THROUGH NH AND VT HEALTH DEPARTMENTS, HOSPITAL DISCHARGE DATA, BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY AND YOUTH RISK BEHAVIOR SURVEYS; FOCUS GROUPS WITH EMPLOYERS AND WITH COMMUNITY MEMBERS RECEIVING SERVICES AT REGIONAL SAFETY NET SERVICE ORGANIZATIONS; ELECTRONIC SURVEYS OF PROFESSIONAL HEALTH AND SOCIAL SERVICE PROVIDERS; AS WELL AS PAPER AND ELECTRONIC CONVENIENCE SURVEYS OF COMMUNITY RESIDENTS. FINDINGS OF THE FY2019 COMMUNITY HEALTH NEEDS ASSESSMENT WERE REVIEWED AT 3 LARGE COMMUNITY MEETING (100+ TOTAL STAKEHOLDERS) HOSTED IN CONCERT WITH THE PUBLIC HEALTH COUNCIL OF THE UPPER VALLEY AND OTHERS FOR FURTHER COMMENTS AND FEEDBACK. ADDITIONALLY, MHMH COMMUNITY HEALTH STAFF PARTICIPATE IN OR LEAD MULTIPLE COMMUNITY COALITIONS AND PROJECTS CONNECTING US TO A WIDE ARRAY OF COMMUNITY-BASED HEALTH, MUNICIPAL, SCHOOL, SERVICE ORGANIZATION, REGIONAL PLANNING AND STATE PUBLIC HEALTH STAKEHOLDERS. WE REGULARLY REVIEW EMERGING NH & VT STATE HEALTH DATA; QUANTITATIVE AND QUALITATIVE DATA FROM LOCAL SOURCES (NEWSPAPERS, REGIONAL PLANNING OFFICES, COMMUNITY FORUMS), AND CONVERSATIONS WITH COMMUNITY PARTNERS TO IDENTIFY CONCERNS THAT ARE EMERGING, INTENSIFYING, OR ARE THE SOURCE OF LOCAL ATTENTION SINCE THE LAST CHNA WAS CONDUCTED.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceALL UNINSURED INPATIENTS, SAME DAY SURGERY, OBSERVATION, AND EMERGENCY DEPARTMENT PATIENTS ARE PRO-ACTIVELY SCREENED USING PAPER AND/OR AN AUTOMATED TOOL TO IDENTIFY POTENTIAL QUALIFICATION FOR OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. IN ADDITION, SPECIFIC OUTPATIENT ACTIVITIES DEEMED TO HAVE A HIGHER RATE OF NEED ARE SCREENED AS PART OF REGULAR PROTOCOL. IF A PATIENT APPEARS TO BE ELIGIBLE, ON-SITE FINANCIAL COUNSELORS ASSIST THE PATIENT IN COMPLETING THE APPROPRIATE PAPERWORK/APPLICATIONS AND PROVIDE INSTRUCTION REGARDING HOW TO COMPLETE THE QUALIFICATION PROCESS. IN SOME CASES A FINANCIAL COUNSELOR WILL ACT ON BEHALF OF THE PATIENT, AT THEIR SIGNED CONSENT, IN ORDER TO COMPLETE THE APPLICATION PROCESS (FOR EXAMPLE, IN NEW HAMPSHIRE A PATIENT MUST BE PHYSICALLY PRESENT AT THE DISTRICT OFFICE). IF A PATIENT DOESN'T QUALIFY FOR SPECIFIC PROGRAMS, THEY ARE ALSO CONSIDERED FOR FINANCIAL ASSISTANCE AS PART OF THEIR SCREENING. FOR OUTPATIENT SERVICES THAT ARE NOT ROUTINELY SCREENED, STAFF INTERACTING WITH PATIENTS ARE INSTRUCTED TO PROVIDE EITHER A FINANCIAL ASSISTANCE APPLICATION OR CONTACT INFORMATION FOR A FINANCIAL COUNSELOR WHEN A PATIENT EXPRESSES THEIR INABILITY TO MAKE PAYMENT. EVERY APPLICATION IS SCREENED FOR COMPLETED INCOME AND ASSET DOCUMENTATION. APPLICATIONS ARE ALSO SCREENED TO ASSURE THERE ARE NO OTHER POTENTIAL OPTIONS OF FEDERAL, STATE, OR LOCAL PROGRAMS. THE WEBSITE, PATIENT STATEMENTS, AND FINANCIAL BROCHURES ALL INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE AND HOW TO APPLY.
Schedule H, Part VI, Line 4 Community informationTHE ORGANIZATION DEFINES ITS SERVICE REGION AS NEW HAMPSHIRE AND EASTERN VERMONT, WITH THE LARGEST PRESENCE IN A 19-TOWN HOSPITAL SERVICE AREA REGION ADJOINING LEBANON, NEW HAMPSHIRE, SITE OF DARTMOUTH-HITCHCOCK MEDICAL CENTER WHICH INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL AND DARTMOUTH-HITCHCOCK CLINIC'S MAIN NORTHERN CLINIC. THE 19-TOWN HOSPITAL SERVICE AREA REGION HAS A POPULATION OF 70,000 PEOPLE, WITH TOWNS RANGING IN POPULATION FROM 200-14,000 PEOPLE. THESE TOWNS ARE GENERALLY CONSIDERED RURAL, THOUGH THE HANOVER, AND LEBANON, NH AND HARTFORD, VT COMMUNITIES ARE CONSIDERED TO BE A MICROPOLITAN AREA. AMONG THE REGION'S 19 TOWNS, MEDIAN HOUSEHOLD INCOME VARIES WIDELY, FROM $50K-$120K ANNUALLY 17.5% OF THE POPULATION IS OVER THE AGE OF 65; 11% OF CHILDREN LIVE IN HOUSEHOLDS WHOSE MEDIAN HOUSEHOLD INCOME IS LESS THAN 100% OF FEDERAL POVERTY LEVEL, 26.8% OF CHILDREN LIVE IN HOUSEHOLDS WITH INCOME LESS THAN 200% OF FEDERAL POVERTY LEVEL; 1.5% OF THE REGION'S RESIDENTS HAVE LIMITED ENGLISH PROFICIENCY; AND 7.1% LACKED HEALTH INSURANCE. 11.8% OF NH RESIDENTS AND 24.9% OF VERMONT RESIDENTS ARE MEDICAID BENEFICIARIES. THE REGION IS SERVED BY MHMH AND BY ALICE PECK DAY MEMORIAL HOSPITALS. THERE ARE NO FEDERALLY QUALIFIED HEALTH CENTERS OPERATING WITHIN THE REGION, THOUGH ONE REGIONAL COMMUNITY HEALTH CLINIC IS PURSUING THIS STATUS. THE GOOD NEIGHBOR HEALTH CLINIC, IN HARTFORD, VT, OFFERS CARE TO UNINSURED COMMUNITY MEMBERS. TWO MINOR CIVIL DIVISIONS IN OUR REGION, DORCHESTER NH AND PIERMONT NH, ARE CONSIDERED MEDICALLY UNDERSERVED AREAS. MHMH SERVES THE GENERAL POPULATION WITH A WIDE RANGE OF SERVICES. IN ADDITION TO GENERAL HOSPITAL POPULATIONS, THE ORGANIZATION PROVIDES SERVICES TO PATIENTS WITH HIGHLY-SPECIALIZED NEEDS THAT ARE NOT AVAILABLE ELSEWHERE IN NEW HAMPSHIRE. MHMH IS THE STATE'S ONLY TERTIARY REFERRAL CENTER, PROVIDES THE STATE'S ONLY COMPREHENSIVE CANCER CENTER (NORRIS COTTON CANCER CENTER ~ NCCC), OPERATES THE ONLY LEVEL I TRAUMA CENTER IN NEW HAMPSHIRE, OPERATES THE ONLY COMPREHENSIVE CHILDREN'S HOSPITAL AND ACCREDITED PEDIATRIC TRAUMA CENTER IN NEW HAMPSHIRE (CHILDREN'S HOSPITAL AT DARTMOUTH - CHAD), HOSTS THE ONLY LEVEL IV NEONATAL INTENSIVE CARE NURSERY AND ONE OF TWO PEDIATRIC INTENSIVE CARE UNITS IN NEW HAMPSHIRE, AND OPERATES THE ONLY HELICOPTER TRANSPORT SERVICE IN THE STATE. AS SUCH, THE SERVICE POPULATION IS BOTH THE GENERAL PUBLIC SEEKING PRIMARY HEALTH CARE SERVICES AS WELL AS RESIDENTS WITH UNIQUE AND HIGHLY-SPECIALIZED HEALTH CARE NEEDS.
Schedule H, Part VI, Line 5 Promotion of community healthMHMH supports organizations and initiatives that further health by strengthening and developing key community capacities to address identified community health needs. This Includes hosting or leading community partnerships to address substance misuse and treatment and to improve public health; providing funding for child and adult oral health initiatives, and participation of our staff in other partnerships including the outpatient Falls Prevention Task Force, the Transportation Management Association, and the Upper Valley workforce Housing Coalition. In addition, MHMH operates health education and support Services such as a Women's Health Resource Center, the Aging Resource Center, and a Health Education Center. MHMH uses cash contributions, contracted services, and in kind Contribution of staff time and expertise, to support these strategies which improve community health. At MHMH's Lebanon, NH campus, the hospital extends professional staff privileges to qualified and appropriate physicians who are employees of Dartmouth Hitchcock Clinic, Mary Hitchcock Memorial Hospital, and Dartmouth College, who also hold a faculty appointment at Geisel School of Medicine. Mary Hitchcock's Trustees annually set strategic priorities for the institution and approve operating and capital budgets which support improvements, patient care, medical education, and research. Examples of these investments include the development of Mary Hitchcock's Patient Safety and Training Center; ongoing quality and patient safety initiatives; purchases of new and emerging medical technologies; support translational research, and medical education. Of The 22 voting members of the MHMH Board of Trustees at FY21 end, 16 are neither Contractors nor employees of MHMH
Schedule H, Part VI, Line 6 Affiliated health care systemCOMMUNITY BENEFITS ARE PROVIDED BY THE DARTMOUTH HITCHCOCK HEALTH CARE SYSTEM, WHICH INCLUDES MARY HITCHCOCK MEMORIAL HOSPITAL, DARTMOUTH-HITCHCOCK CLINIC, AND OTHER RELATED ORGANIZATIONS WHOSE PRIMARY MISSION IS HEALTH CARE. MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) IN LEBANON IS NEW HAMPSHIRE'S LARGEST HOSPITAL. IN FISCAL YEAR 2021 MHMH HAD 396 LICENSED INPATIENT BEDS. THE DARTMOUTH-HITCHCOCK CLINIC (DHC) IS A MULTI-SPECIALTY PHYSICIAN PRACTICE WITH A NETWORK OF PROVIDERS ACROSS NEW HAMPSHIRE AND VERMONT. WHILE DHC'S MAIN OFFICES ARE LOCATED IN LEBANON, THE CLINIC ALSO HAS MULTI-SPECIALTY PRACTICES IN MANCHESTER, NASHUA, CONCORD, AND KEENE, NH AREAS AS WELL AS BENNINGTON, VT. IN ADDITION, THE CLINIC PROVIDES PRIMARY CARE IN RURAL COMMUNITIES IN VERMONT AND NORTHERN NEW HAMPSHIRE. THE HOSPITAL AND CLINIC OPERATE JOINTLY THROUGH INTERLOCKING DIRECTORATES, STRATEGIC PLANNING AND MANAGEMENT AND SHARE IDENTICAL MISSIONS. THE MEDICAL SCHOOL, WHICH WORKS CLOSELY WITH THE HOSPITAL AND CLINIC, IS FOCUSED ON MEDICAL EDUCATION AND RESEARCH.
Schedule H, Part VI, Line 7 State filing of community benefit reportNH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (122 entries)

Address Line1USAddress/AddressLine1TxtAddress Line2USAddress/AddressLine2TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
Advance Transit
PO BOX 68344 WASHINGTON AVENUESCARBOROUGHME040706834222558708501(c)3$84,163FMVPROGRAM SUPPORT
Alice Peck Day Memorial Hospital
ATTN MATTHEW HARRIS10 ALICE PECK DAY DRIVELEBANONNH03766020222791501(c)3$17,750FMVPROGRAM SUPPORT
American Cancer Society
2 COMMERCE DRIVEBEDFORDNH03110131788491501(c)3$28,045FMVPROGRAM SUPPORT
American University of Beirut
PO BOX 76349BALTIMOREMD212756349135596846501(c)3$8,453FMVPROGRAM SUPPORT
Amoskeag Health
145 HOLLIS STREETMANCHESTERNH03101020458174501(c)3$35,500FMVPROGRAM SUPPORT
ATRIUM HEALTH
CAROLINAS HEALTHCARE SYSTEMc/o THERAPEUTIC RESEARCH DEVCHARLOTTENC282601979560529945501(c)3$12,422FMVCHARITABLE RESEARCH
BAYLOR COLLEGE OF MEDICINE
PO BOX 301207DALLASTX753031207741613878501(c)3$77,813FMVCHARITABLE EDUCATIONAL SERVICES
BOSTON MEDICAL CENTER
PO BOX 28763RESEARCH FINANCE ANALYSTBOSTONMA02118043314093501(c)3$8,820FMVCHARITABLE RESEARCH
BOSTON UNIVERSITY
ROOM 2B02NEW YORKNY100878763042103547501(c)3$208,288FMVCHARITABLE RESEARCH
BRD OF REGENTS UNIV OF OK HLTH SCIENCE
ATTN ELTA ETIENNE4502 E 41ST STREETTULSAOK741352512731563627STATE OF OK$9,137FMVEDUCATIONAL SERVICES
BRIGHAM AND WOMEN'S HOSPITAL INC
75 FRANCIS STBOSTONMA02115042312909501(c)3$150,009FMVCHARITABLE RESEARCH
Business and Industry Association
122 NORTH MAIN STREETCONCORDNH03301020172300501(c)6$9,230FMVPROGRAM SUPPORT
Catholic Medical Center
100 MCGREGOR STREETMANCHESTERNH03102020315693501(c)3$5,325FMVPROGRAM SUPPORT
CEDARS-SINAI MEDICAL CENTER
6500 WILSHIRE BLVD SUITE 1150SPONSORED RESEARCH FUNDS ADMINLOS ANGELESCA90048951644600501(c)3$140,669FMVCHARITABLE RESEARCH
CENTERSTONE OF KENTUCKY INC
10101 LINN STATION RD STE 600LOUISVILLEKY40223310939757501(c)3$10,896FMVCHARITABLE RESEARCH
CENTERSTONE RESEARCH INSTITUTE INC
44 VANTAGE WAYNASHVILLETN37228262505456501(c)3$181,393FMVCHARITABLE RESEARCH
Cheshire Medical Center
580 COURT STREETKEENENH03431020354549501(c)3$301,645FMVPROGRAM SUPPORT
CHILDREN'S HOSPITAL
PO BOX D-3053300 LONGWOOD AVENUEBOSTONMA02115042774441501(c)3$24,329FMVCHARITABLE RESEARCH
CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BOULEVARD13123 EAST 16TH AVE BOX 010LOS ANGELESCA90027195612191501(c)3$17,224FMVCHARITABLE RESEARCH
CITY OF LEBANON
WATER SEWER DEPT51 NORTH PARK STREETLEBANONNH03766026000473City of Lebanon$198,380FMVEDUCATIONAL SERVICES
CLEVELAND CLINIC FOUNDATION
PO BOX 9315629500 EUCLID AVECLEVELANDOH44195340714585501(c)3$33,603FMVCHARITABLE RESEARCH
Colby Sawyer College
2400 LAKEVIEW PARKWAYALPHARETTAGA30009020222120501(c)3$1,000,000FMVPROGRAM SUPPORT
COMMONWEALTH OF MASSACHUSETTS
DEPT OF REVENUECHILD SUPPORT ENF DIVISIONBOSTONMA022055140046002284STATE OF MA$113,366FMVEDUCATIONAL SERVICES
COMMUNITY MENTAL HEALTH AFFILIATES INC
270 JOHN DOWNEY DRNEW BRITAINCT06051060934544501(c)3$6,421FMVCHARITABLE PROGRAM SUPPORT
COOS COUNTY FAMILY HEALTH SERVICES
133 PLEASANT STREETBERLINNH03570020350051501(c)4$8,141FMVCHARITABLE PROGRAM SUPPORT
CREARE LLC
16 GREAT HOLLOW RDHANOVERNH03755020259551$15,635FMVCHARITABLE RESEARCH
Cronin & Company
1648 LAWSON STDURHAMNC277035024844802742$77,425FMVPROGRAM SUPPORT
DUKE UNIVERSITY
ACCOUNTS RECEIVABLE LOCKBOX2400 PRATT AVE STE 9100-RM9314CHARLOTTENC27710560532129501(c)3$14,268FMVCHARITABLE EDUCATIONAL SERVICES
Easter Seals of NH
555 AUBURN STREETMANCHESTERNH03103020272825501(c)3$8,165FMVPROGRAM SUPPORT
FAMILIES FLOURISH NORTHEAST INC
PO BOX 20ENFIELD CENTERNH03749844591232501(c)3$32,685FMVCHARITABLE PROGRAM SUPPORT
Families in Transition
100 CAMPUS DR STE 12PORTSMOUTHNH03801020475414501(c)3$32,394FMVPROGRAM SUPPORT
FAMILY PLACE INC
319 US ROUTE 5 SOUTHNORWICHVT05055030305264501(c)4$37,067FMVCHARITABLE PROGRAM SUPPORT
FEINSTEIN INSTITUTES FOR MEDICAL RESEARC
350 COMMUNITY DRIVEMANHASSETNY11030112673595501(c)3$3,875FMVCHARITABLE RESEARCH
Foundation for Healthy Communities (NHHA)
125 AIRPORT ROADCONCORDNH03301020275078501(c)3$1,040,237FMVPROGRAM SUPPORT
Good Neighbor Health Clinic
70 NORTH MAIN STREETWHITE RIVER JCTVT05001030346949501(c)3$46,150FMVPROGRAM SUPPORT
Grafton County Senior Citizens Council
ATTN ROBERTA BERNERPO BOX 433LEBANONNH03766237248316501(c)3$12,780FMVPROGRAM SUPPORT
Granite United Way
22 CONCORD STREETFLOOR 2MANCHESTERNH03101026006033501(c)3$28,400FMVPROGRAM SUPPORT
HARVARD UNIVERSITY
HARVARD MED-CMEPO BOX 825BOSTONMA021170825042103580501(c)3$12,796FMVCHARITABLE EDUCATIONAL SERVICES
Headrest Inc
PO BOX 74008204CHICAGOIL606748204237256865501(c)3$29,465FMVPROGRAM SUPPORT
HIVHCV Resource Center
2 BLACKSMITH STLEBANONNH03766223104237501(c)3$17,750FMVPROGRAM SUPPORT
Listen Community Services
60 HANOVER STLEBANONNH03766237225952501(c)3$14,200FMVPROGRAM SUPPORT
MAPS COUNSELING SERVICES
19 FEDERAL STREETKEENENH03431020312473501(c)3$18,742FMVCHARITABLE PROGRAM SUPPORT
March of Dimes
1 ETNA HIGHLANDS ROADETNANH03750131846366501(c)3$10,650FMVPROGRAM SUPPORT
MASSACHUSETTS GENERAL HOSPITAL
100 CHARLES RIVER PLAZA STE 600DEVELOPMENT OFFICEBOSTONMA021142792042697983501(c)3$318,006FMVCHARITABLE RESEARCH
MAYFLOWER MEDICAL OUTREACH INC
PO BOX 75449OKLAHOMA CITYOK73147271245528501(c)3$4,137FMVCHARITABLE RESEARCH
MAYO CLINIC
13400 EAST SHEA BOULEVARDPO BOX 603644ROCHESTERMN55903416011702501(c)3$14,495FMVCHARITABLE RESEARCH
MAYO CLINIC ARIZONA
PO BOX 4003SCOTTSDALEAZ85259860800150501(c)3$4,029FMVCHARITABLE RESEARCH
MEDICAL UNIVERSITY OF SOUTH CAROLINA
COLLEGE OF NURSING AT P BONHAMCHARLESTONSC29407576000722STATE OF SC$209,005FMVEDUCATIONAL SERVICES
MEMORIAL SLOAN-KETTERING CANCER CENTER
PO BOX 27084NEW YORKNY100876352131924236501(c)3$23,774FMVCHARITABLE RESEARCH
MICHIGAN STATE UNIVERSITY
GRANTS CONTRACT ADMINISTRATIONROOM 360EAST LANSINGMI48824386005984STATE OF MI$18,836FMVEDUCATIONAL SERVICES
Monadnock Family Services
17 93RD STACCOUNTS RECEIVABLE DEPTKEENENH03431026012230501(c)3$209,205FMVPROGRAM SUPPORT
Mt Ascutney Hospital and Health Center
ATTN MARTHA COLBURN289 COUNTY ROADWINDSORVT05089030183721501(c)3$17,750FMVPROGRAM SUPPORT
Nackey S Loeb School of Communication
PO BOX 531107ORLANDOFL328531107020507891501(c)3$10,000FMVPROGRAM SUPPORT
NAMI NH
85 NORTH STATE STREETCONCORDNH03301222760743501(c)3$9,472FMVCHARITABLE PROGRAM SUPPORT
New England Council Inc
98 NORTH WASHINGTON STBOSTONMA02114041661090501(c)3$7,500FMVPROGRAM SUPPORT
New Hampshire Business for Social Responsibility
155 DOW STREETMANCHESTERNH03101020529708501(c)3$5,325FMVPROGRAM SUPPORT
New Hampshire Charitable Foundation
215 MYRTLE STREETMANCHESTERNH031044354026005625501(c)3$42,600FMVPROGRAM SUPPORT
New Hampshire Coalition Against Domestic Violence
215 MYRTLE STREETMANCHESTERNH031044354020360151501(c)3$14,200FMVPROGRAM SUPPORT
New Hampshire Women's Foundation
18 LOW AVENUECONCORDNH03301020495092501(c)3$12,425FMVPROGRAM SUPPORT
New London Hospital
PFS- POSTING CLERKS273 COUNTY RDNEW LONDONNH03257020222171501(c)3$77,359FMVPROGRAM SUPPORT
NH Children's Trust Inc
37 PLEASANT STREETCONCORDNH03301272458454501(c)3$5,325FMVPROGRAM SUPPORT
NORTHWESTERN UNIVERSITY
DEPT OF MEDICAL SOCIAL SERVICES633 NORTH ST CLAIR STREETCHICAGOIL60611362167817501(c)3$10,782FMVCHARITABLE EDUCATIONAL SERVICES
OHIO STATE UNIVERSITY
OFFICE OF SPONSORED PROGRAMS1960 KENNY ROADCOLUMBUSOH43210316025986STATE OF OH$12,796FMVEDUCATIONAL SERVICES
OPEN SKY COMMUNITY SERVICES
4 MANN STREETWORCESTERMA01602042587863501(c)3$18,929FMVCHARITABLE PROGRAM SUPPORT
OREGON CLINIC PC
847 NE 19TH AVENUEPORTLANDOR97232931127856$29,209FMVCHARITABLE RESEARCH
OREGON HEALTH & SCIENCE UNIVERSITY
PO BOX 575PORTLANDOR97207931176109501(c)3$54,535FMVCHARITABLE EDUCATIONAL SERVICES
OREGON STATE UNIVERSITY
1500 SW JEFFERSON WAY1776 MILLRACE DRIVECORVALLISOR97331611730890STATE OF OR$8,601FMVEDUCATIONAL SERVICES
Palace Theatre Trust
80 HANOVER STREETMANCHESTERNH03101237356019501(c)3$3,550FMVPROGRAM SUPPORT
PROVIDENCE CENTER
528 NORTH N MAIN STREETPROVIDENCERI02860050316969501(c)3$109,476FMVCHARITABLE RESEARCH
PUBLIC HEALTH COUNC OF THE UPPER VALLEY
ONE COURT STREETLEBANONNH03766752991608501(c)3$33,042FMVCHARITABLE PROGRAM SUPPORT
Public Health Council of the Upper Valley
ONE COURT STREETLEBANONNH03766752991608501(c)3$47,570FMVPROGRAM SUPPORT
RECTOR & VISITORS OF UNIV OF VIRGINIA
JOHN W STEINKEPO BOX 801355CHARLOTTESVILLEVA229081355546001796STATE OF VA$20,246FMVEDUCATIONAL SERVICES
REGENTS OF THE UNIVERSITY OF CALIFORNIA
UCSD CAMPUS MAIN DEPOSITORY9500 GILMAN DRIVE MC 0009LOS ANGELESCA920930009943067788STATE OF CA$25,775FMVEDUCATIONAL SERVICES
REGENTS OF UNIV OF MICHIGAN
DEPT OF PATHOLOGY BILLING2800 PLYMOUTH ROADANN ARBORMI48109386006309STATE OF MI$103,000FMVEDUCATIONAL SERVICES
RESEARCH INSTITUTE AT NATIONWIDE CHILDRE
PO BOX 781653140 OLD ORANGEBURG ROAD BLDG 35DETROITMI48278316056230501(c)3$24,843FMVCHARITABLE RESEARCH
RHODE ISLAND HOSPITAL
PO BOX 373PROVIDENCERI02901050258954501(c)3$50,845FMVCHARITABLE RESEARCH
Riverbend Community Mental Health Inc
SUZANNE GROENWOLD307 SOUTH STREETSPRINGFIELDVT05156020264383501(c)3$7,100FMVPROGRAM SUPPORT
SEATTLE CHILDREN'S HOSPITAL
PO BOX 24728SEATTLEWA981240728910564748501(c)3$72,235FMVCHARITABLE RESEARCH
SEVEN COUNTIES SERVICES INC
10101 LINN STATION ROAD2491 WEHRLE DRIVELOUISVILLEKY40223310939757501(c)3$156,279FMVCHARITABLE RESEARCH
SINAI HOSPITAL OF BALTIMORE INC
2401 W BELVEDERE AVENUEBALTIMOREMD21215520486540501(c)3$35,409FMVCHARITABLE RESEARCH
Southeast Vermont Transit Inc
5830 NW 163RD STREETMIAMI LAKESFL33014030353976501(c)3$21,300FMVPROGRAM SUPPORT
Southwestern Community Services
37 ASHUELOT STREETKEENENH03431026013808501(c)3$19,170FMVPROGRAM SUPPORT
SOUTHWESTERN COMMUNITY SERVICES INC
63 COMMUNITY WAY63 COMMUNITY WAYKEENENH03431026013808501(c)3$9,142FMVCHARITABLE RESEARCH
Spearmc Management Consulting Inc
ATTN ALICE LAMY16 HOSPITAL RDPLYMOUTHNH03264470937480501(c)3$5,254FMVPROGRAM SUPPORT
STANFORD UNIVERSITY
3145 PORTER DRIVEPALO ALTOCA94305941156365501(c)3$38,987FMVCHARITABLE EDUCATIONAL SERVICES
Sullivan County
14 MAIN STREETNEWPORTNH03773026000870Newport$46,150FMVPROGRAM SUPPORT
The ALS Association
THE CONCORD CENTER10 FERRY STREETCONCORDNH03301133271855501(c)3$8,875FMVPROGRAM SUPPORT
The Trustees at Dartmouth College
PO BOX 310456DES MOINESIA50331020222111501(c)3$8,489FMVPROGRAM SUPPORT
TLC FAMILY RESOURCE CENTER
PO BOX 1098CLAREMONTNH03743522439830501(c)3$21,031FMVCHARITABLE PROGRAM SUPPORT
TOWN OF HANOVER
ATTN TAX COLLECTOR41 SOUTH MAIN STREETHANOVERNH03755026000371Town of Hanover$5,688FMVEDUCATIONAL SERVICES
Tri-Valley Transit
DEPT 106091PO BOX 150502HARTFORDCT061150502030335768501(c)3$20,058FMVPROGRAM SUPPORT
TRUSTEES OF DARTMOUTH COLLEGE
CASHIERS OFFICE / ARDARTMOUTH COLLEGEHANOVERNH03755020222111501(c)3$1,380,645FMVCHARITABLE EDUCATIONAL SERVICES
TRUSTEES OF THE UNIV OF PENNSYLVANIA
THE WHARTON SCHOOLLOCKBOX 9726PHILADELPHIAPA191789726231352685STATE OF PA$38,321FMVEDUCATIONAL SERVICES
Twin Pines Housing Trust
226 HOLIDAY DRIVEWHITE RIVER JCTVT05001222809527501(c)3$28,400FMVPROGRAM SUPPORT
United Way of Greater Nashua
20 BROAD STREETNASHUANH03064026015642501(c)3$14,200FMVPROGRAM SUPPORT
UNIV SYSTEM OF NEW HAMPSHIRE
5 CHANELL DRIVECONCORDNH03824026000937STATE OF NH$8,229FMVEDUCATIONAL SERVICES
UNIVERSITY OF ALABAMA AT BIRMINGHAM
GRANTS CONTRACTS ACCOUNTINGATTN CYNTHIA HELMSBIRMINGHAMAL352941210636005396STATE OF AL$427,930FMVEDUCATIONAL SERVICES
UNIVERSITY OF ARIZONA
1303 E UNIVERSITY BLVDTUCSONAZ857190521742652689STATE OF AZ$13,088FMVEDUCATIONAL SERVICES
UNIVERSITY OF COLORADO
UCHSC DNA DIAGNOSTIC LABMAIL STOP 8313 PO BOX 6511AURORACO80045846000555STATE OF CO$50,794FMVEDUCATIONAL SERVICES
UNIVERSITY OF MARYLAND
ACCOUNTING AND COMPLIANCE220 ARCH STREET OFFICE LEVEL 2BALTIMOREMD212011531526002033STATE OF MD$138,302FMVEDUCATIONAL SERVICES
UNIVERSITY OF MIAMI
DEPARTMENT OF PATHOLOGYPO BOX 405776ATLANTAGA303845776592695890STATE OF FL$5,005FMVEDUCATIONAL SERVICES
UNIVERSITY OF NEBRASKA MEDICAL CTR
985100 NEBRASKA MED CTROMAHANE681985045470491233STATE OF NE$23,857FMVEDUCATIONAL SERVICES
UNIVERSITY OF PITTSBURGH
FORBES ALLIES BUILDING STE 3003109 FORBES AVENUEPITTSBURGHPA15213250965591STATE OF PA$62,862FMVEDUCATIONAL SERVICES
UNIVERSITY OF ROCHESTER
SCHOOL OF NURSINGEDVANTAGE ATTN REGISTRATIONROCHESTERNY14642160743209501(c)3$138,405FMVCHARITABLE EDUCATIONAL SERVICES
UNIVERSITY OF UTAH
DEPT OF NEUROSURGERY175 N MEDICAL DRIVE EASTSALT LAKE CITYUT84132876000525STATE OF UT$6,063FMVEDUCATIONAL SERVICES
UNIVERSITY OF VERMONT
PO BOX 1063ATTN CORPORATE ACCOUNTINGBURLINGTONVT05402030179440STATE OF VT$9,902FMVEDUCATIONAL SERVICES
UNIVERSITY OF WASHINGTON
GRANT CONTRACT ACCOUNTING12455 COLLECTIONS DRIVECHICAGOIL60693916001537STATE OF WA$78,594FMVEDUCATIONAL SERVICES
Upper Valley Community Nursing Project
PO BOX 1302LEBANONNH03766831224873501(c)3$14,200FMVPROGRAM SUPPORT
Upper Valley Haven
713 HARTFORD AVEWHITE RIVER JCTVT05001030277908501(c)3$60,794FMVPROGRAM SUPPORT
Vermont Medical Society
134 MAIN STREETPO BOX 1457MONTPELIERVT056011457030164911501(c)3$7,000FMVPROGRAM SUPPORT
VINFEN CORPORATION
950 CAMBRIDGE STCAMBRIDGEMA02141042632219501(c)3$27,021FMVCHARITABLE PROGRAM SUPPORT
VIRGINIA COMMONWEALTH UNIVERSITY
BOX 843035RICHMONDVA23219546001758STATE OF VA$28,010FMVEDUCATIONAL SERVICES
Vital Communities
195 NORTH MAIN STREETWHITE RIVER JCTVT05001030355283501(c)3$17,750FMVPROGRAM SUPPORT
VNA at HCS INC
312 MARLBOROUGH STREETPO BOX 564KEENENH03431020360640501(c)3$5,369FMVCHARITABLE PROGRAM SUPPORT
Waypoint
PO BOX 448MANCHESTERNH031050448020222164501(c)3$21,300FMVPROGRAM SUPPORT
WEILL MEDICAL COLLEGE OF CORNELL UNIV
ATTN CORNELL ECHO 2001NEW YORKNY10021131623978501(c)3$88,951FMVCHARITABLE EDUCATIONAL SERVICES
West Central Behavioral Health
ATTN SUELLEN GRIFFIN9 HANOVER STREETLEBANONNH03766222645978501(c)3$88,967FMVPROGRAM SUPPORT
WEST VIRGINIA UNIVERSITY RESEARCH CORPOR
ONE WATERFRONT PLACE4TH-FLOOR - PO BOX 6001MORGANTOWNWV265066001550665758STATE OF WV$23,388FMVEDUCATIONAL SERVICES
Willing Hands Enterprises
198 CHURCH STREETNORWICHVT05055202204811501(c)3$22,010FMVPROGRAM SUPPORT
Women's Information Service of the Upper Valley
PO BOX 685CONCORDNH03301020346512501(c)3$14,200FMVPROGRAM SUPPORT
YALE UNIVERSITY
ATTN HILMEL AYUSO EMERG MED464 CONGRESS AVE SUITE 260NEW HAVENCT06519060646973501(c)3$23,272FMVCHARITABLE EDUCATIONAL SERVICES
HITCHCOCK FOUNDATION
ONE MEDICAL CENTER DRIVELEBANONNH03756020222139501(c)3$771,041FMVProgram support
FieldValueIRS element (for citing)
Total501c3 Org116Total501c3OrgCnt
Total Other Org6TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDesc
Awards and Educational Assistance78$516,760FMV
Patient Assistance3194$73,576FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.FormAndLineReferenceDesc
ExplanationEACH AWARD ESTABLISHED BY MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH) HAS WRITTEN GUIDELINES AND PROCEDURES. AWARD PAYMENTS ARE PROCESSED IN ACCORDANCE WITH THE SPECIFIC TERMS OF EACH AWARD. THE DARTMOUTH INSTITUTE SCHOLARSHIPS (TDI) ARE PAID DIRECTLY TO DARTMOUTH COLLEGE ON BEHALF OF THE INDIVIDUALS RECEIVING THE AWARDS. THE COORDINATORS OF THE PROGRAM ARE RESPONSIBLE FOR ASSURING THAT ALL TERMS ARE MET, INCLUDING PROPER DOCUMENTATION OF EXPENSES WITH RECEIPTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsYes (true)CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (33 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Joanne M Conroy MD
Trustee, Ex-Officio, CEO$0$1,325,265$0$0$0$156,395$0$27,315$0$20,654$0$1,529,629$0$0
Jocelyn Chertoff MD
VP Service Line / DPT CHR Diagnostic Radiology$0$669,871$0$0$0$69,861$0$27,315$0$19,007$0$786,054$0$0
Cherie Holmes MD
Trustee (thru 12/31/20)/Physician$0$482,870$0$0$0$43,688$0$27,315$0$18,476$0$572,349$0$0
Jon Wahrenberger MDFAHAFAC
Trustee (thru 12/31/20) / Physician$0$272,759$0$0$0$24,990$0$27,315$0$34,618$0$359,682$0$0
KURT K RHYNHART MD
TRUSTEE/Divisional Chief of Trauma$0$461,521$0$0$0$40,094$0$25,140$0$24,121$0$550,876$0$0
JONATHAN HUNTINGTON MD PhD MPH
TRUSTEE (thru 5/31/21) / Academics CMO$0$439,781$0$0$0$33,370$0$21,615$0$41,503$0$536,269$0$0
Carl W Dobson MD
Trustee (eff. 1/1/21) / Medical Director$406,538$0$39,000$0$19,770$0$14,250$0$41,727$0$521,285$0$0$0
Gary L Freed MD
Trustee (effective 1/1/21) / Physician$0$700,698$0$0$0$63,926$0$21,615$0$7,970$0$794,209$0$0
Aaron J Mancuso MD
Trustee (Eff. 6/1/21) / Physician$0$451,814$0$0$0$9,447$0$12,969$0$40,231$0$514,461$0$0
Richard I Rothstein MD
Former Dept. Chair / Service Line LDR - MED$0$636,624$0$0$0$47,778$0$27,315$0$34,894$0$746,611$0$0
Aimee M Claiborne
Chief HR Officer$420,621$0$0$0$49,117$0$21,615$0$38,271$0$529,624$0$0$0
DANIEL P JANTZEN
Chief Financial Officer$694,897$0$0$0$101,044$0$27,315$0$33,682$0$856,938$0$0$0
Patrick F Jordan III MBA
Chief Operating Officer$707,368$0$0$0$49,213$0$21,615$0$37,984$0$816,180$0$0$0
JOHN KACAVAS
Chief Legal Officer$609,953$0$0$0$117,696$0$27,315$0$38,959$0$793,923$0$0$0
Stephen Leblanc
Chief Strategy Officer$0$683,250$0$0$0$102,875$0$27,315$0$33,682$0$847,122$0$0
EDWARD MERRENS
Chief Clinical Officer$0$662,631$0$0$0$76,722$0$27,315$0$20,130$0$786,798$0$0
Maria Padin MD
Chief Medical Officer$0$467,964$0$45,000$0$39,626$0$27,315$0$42,718$0$622,623$0$0
Susan A Reeves EDDRN
Executive VP (medical center)$553,593$0$250$0$34,829$0$0$0$39,469$0$628,141$0$0$0
Martin Purcell MBA
Chief Information Officer$420,780$0$0$0$49,284$0$27,315$0$28,254$0$525,633$0$0$0
Matthew Haag
VP Development$375,989$0$38,660$0$29,222$0$21,615$0$17,521$0$483,007$0$0$0
GEORGE T BLIKE MD
Former/ Chief Quality & Value Officer$0$344,982$0$0$0$55,025$0$27,315$0$22,825$0$450,147$0$0
Christine Schon MPA
FMR KEY EMP/ ADM VP PRMRY CARE$0$341,947$0$0$0$31,427$0$27,315$0$26,666$0$427,355$0$0
Peter D Solberg MD
Former key/Chief Health Information Officer$0$423,124$0$0$0$25,871$0$27,315$0$40,977$0$517,287$0$0
Sandra Wong MD
Former/SVP SVC LN & Chair of Surgery$0$679,177$0$0$0$59,524$0$21,615$0$14,298$0$774,614$0$0
Karen Clements RNBSNMSB
Chief Nursing Officer$349,699$0$250$0$27,648$0$21,615$0$15,612$0$414,824$0$0$0
Staci Hermann PHARMDMS
Chief Pharmacy Officer$277,779$0$0$0$23,159$0$12,959$0$16,684$0$330,581$0$0$0
Simon Hillier
Dept. Chair - Anesthesiology$0$569,192$0$0$0$53,395$0$27,315$0$34,617$0$684,519$0$0
Jeffrey Obrien MHA
VP Clinical Operations$366,117$0$0$0$28,367$0$27,315$0$37,970$0$459,769$0$0$0
Wendy Fielding MBA
FMR KEY EMP / VP FINANCE PLANNING$284,435$0$0$0$27,008$0$21,615$0$40,261$0$373,319$0$0$0
Kimberly Troland JD
Deputy Gen Counsel$389,097$0$0$0$46,704$0$21,615$0$21,400$0$478,816$0$0$0
David Gladstone MD
CHF CLNCL PHYSCN - RADIOLOGY$326,374$0$0$0$53,910$0$27,315$0$31,229$0$438,828$0$0$0
Leigh Burgess
VP RESEARCH OPS$274,886$0$0$0$139,731$0$22,485$0$27,426$0$464,528$0$0$0
Curtis Lancaster
VP- Supply Chain$326,444$0$0$0$3,549$0$21,615$0$41,885$0$393,493$0$0$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1a Health or social club dues or initiation feesTHE ORGANIZATION HAS IN PLACE A MANAGEMENT SELF DEVELOPMENT PLAN (MSDP) DESIGNED TO PROMOTE PROFESSIONAL AND PERSONAL DEVELOPMENT. THE MSDP IS CAPPED AT 2% OF GROSS PAY AND MAY BE UTILIZED FOR EXPENSES SUCH AS PROFESSIONAL DUES, MEETINGS AND SEMINARS, TUITION REIMBURSEMENT, AND OTHER MISCELLANEOUS ITEMS THAT PROMOTE PROFESSIONAL KNOWLEDGE. THE MONIES MAY ALSO BE USED FOR UP TO A 50% REIMBURSEMENT OF THE COST OF A FITNESS/WELLNESS PROGRAM DESIGNED TO MAINTAIN THE HEALTH OF MANAGEMENT PERSONNEL. ALL EXPENSES ARE SUBMITTED FOR APPROVAL BEFORE REIMBURSEMENT.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationTHE CEO IS PAID BY DARTMOUTH-HITCHCOCK CLINIC (DHC), A RELATED ORGANIZATION, WHICH USES A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE CEO'S COMPENSATION.
Schedule J, Part I, Line 4a Severance or change-of-control paymentLeigh Burgess was paid severance in the amount of $120,550 during calendar 2020 as a result of a voluntary separation agreement entered into in FY21.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planDartmouth Hitchcock Clinic (DHC) and Mary Hitchcock Memorial Hospital (MHMH) sponsor a split dollar life plan for certain long-term employees. The original objectives for offering these plans were to better enable DHC and MHMH to attract and retain quality executive personnel, improve the physicians' post-retirement life insurance benefits, and to replace an increasingly costly retiree life insurance program. The plan was frozen to new participants in 1998. The number of participants and dollar value continues to dwindle as individuals retire/leave the organization. THE FOLLOWING INDIVIDUALS HAVE A SPLIT DOLLAR LIFE PLAN ARRANGEMENT AND RESPECTIVE EMPLOYER PREMIUMS: DANIEL JANTZEN $135,240 STEPHEN LEBLANC $61,630 RICHARD ROTHSTEIN $105,722
Schedule J, Part I, Line 5b Compensation contingent on revenues of a related organizationMatthew Haag's bonus is based on gross revenue received of a related organization.
Schedule J, Part II NOTE REGARDING COMPENSATIONFORM 990, SCHEDULE J, PART II COLUMN B, PARTS I, II, AND III REPRESENT ACTUAL AMOUNTS PAID TO EMPLOYEES BY MHMH AND RELATED ORGANIZATIONS. THESE AMOUNTS ARE REPORTED TO EMPLOYEES ON THEIR ANNUAL W-2 FORMS AS COMPENSATION. COLUMNS C AND D REPRESENT ITEMS EARNED, HOWEVER, NOT PAID DIRECTLY TO THE EMPLOYEE AS CASH PAYMENTS DURING THE CALENDAR YEAR. COLUMN C INCLUDES RETIREMENT BENEFITS IN A CALENDAR YEAR. COLUMN D REPRESENTS NONTAXABLE BENEFITS SUCH AS THE COST OF HEALTHCARE COVERAGE PROVIDED BY D-H ON BEHALF OF ITS EMPLOYEES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
NH HEALTH AND ED FACILITIES AUTHORITY
A0202798666446142B42014-08-13$41,242,990REFUND ISSUE DATED 08/19/2009falsefalsefalse
NH HEALTH AND ED FACILITIES AUTHORITY
B0202798660000000002016-07-01$35,575,000SEE PART VIfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndCapital ExpendituresCapitalExpendituresAmt
A$14,575,000$41,242,990$352,990$40,890,0002014Yes (true)falseYes (true)Yes (true)
B$24,605,000$35,575,000$408,058$19,230,3262017Yes (true)falseYes (true)Yes (true)$15,936,616

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
Afalsefalsefalsefalse0.00.00.0falsefalseYes (true)
BfalseYes (true)falsefalse0.00.00.0falsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
AfalsefalsefalseYes (true)falsefalsefalsefalseYes (true)
BfalseYes (true)falsefalsefalsefalsefalsefalseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule K, Part I, Column (f) Bond BTHE PURPOSE OF THE ISSUE WAS TO REFUND AN ISSUE DATED 10/24/2013 AND FINANCE CAPITAL PROJECTS.
Schedule K, Part I, Column (a) Bonds A & BNEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY.
Schedule K, Part I Rows 2c, Bond AAN ARBITRAGE REBATE CALCULATION WAS PREFORMED ON 09/18/2019.
Schedule K, Part IV, Line 2c COLUMN AIssuer name: NH HEALTH AND ED. FACILITIES AUTHORITY The calculation for computing no rebate due was performed on 09/18/2019

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
DANIEL JANTZEN
OFFICERSPLIT DOLLAR LIFEYes (X)$0$135,240falseYes (true)Yes (true)
DEBORAH JANTZEN
FAMILY MEMBERSPLIT DOLLAR LIFEYes (X)$0$67,549falseYes (true)Yes (true)
FieldValueIRS element (for citing)
Total Balance Due$202,789TotalBalanceDueAmt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution17ContributionCnt
Noncash Contributions Rpt F990$3,286,487NoncashContributionsRptF990Amt
Method Of Determining RevenuesMarket valueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedYes (true)ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributionsTHE ORGANIZATION USES DARTMOUTH-HITCHCOCK HEALTH, MHMH'S PARENT ORGANIZATION, FOR SOLICITATION OF CONTRIBUTIONS AND ANNUAL FUND ACTIVITIES.
Schedule M, Part I Explanations of reporting method for number of contributionsSecurities - Publicly traded - MHMH is reporting the number of contributors of stock.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15a OFFICES & POSITIONS FOR WHICH PROCESS WAS USED & YEAR UNDERTAKENALTHOUGH PAID BY A RELATED ORGANIZATION, DARTMOUTH-HITCHCOCK CLINIC, THE COMPENSATION FOR THE CEO IS EVALUATED BY AN INDEPENDENT THIRD PARTY FIRM FOR REASONABLENESS AND NATIONAL DATA BENCHMARKING. THE TALENT DEVELOPMENT AND COMPENSATION COMMITTEE, ALONG WITH INDEPENDENT TRUSTEES, APPROVE THE FINAL COMPENSATION IN CONSIDERATION WITH THE INDEPENDENT THIRD PARTY FIRM'S RECOMMENDATIONS AND SUGGESTIONS. THIS PROCESS WAS CONTEMPORANEOUSLY DOCUMENTED AND LAST UNDERTAKEN IN 2021.
Form 990, Part VI, Line 1a Delegate broad authority to a committeeThe Mary Hitchcock Memorial Hospital (MHMH) board has a Governance Committee who has the authority/responsibility of the MHMH Board to ensure that MHMH continues to fulfill its central mission and vision. This committee has authority to act on behalf of the full Board when the need arises. Members include the following who are all members of the governing board: Edward H. Stansfield, III, MA (Board Chair and Chair of Governance Committee) Jennifer L. Moyer, MBA (Chair - Talent Development and Compensation Committee) Roberta L. Hines, MD (Chair - Research and Education Committee) Charles G. Plimpton, MBA (Chair- Finance Committee) Pamela A. Thompson, MS, RN, CENP, FAAN (Chair - Value Committee) Ex Officio member: Dr. Joanne Conroy (CEO)
Form 990, Part VI, Line 6 Classes of members or stockholdersDARTMOUTH-HITCHCOCK HEALTH (D-HH) IS THE SOLE CORPORATE MEMBER OF MARY HITCHCOCK MEMORIAL HOSPITAL (MHMH).
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyD-HH HAS SPECIFIC AUTHORITY AND RESERVED POWERS, INCLUDING THE POWER TO CONFIRM THE ELECTION OF MEMBERS OF MHMH'S BOARD OF TRUSTEES AND THE POWER TO APPROVE SIGNIFICANT GOVERNANCE, FINANCIAL, AND OPERATIONAL DECISIONS OF MHMH'S TRUSTEES.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersIN ADDITION TO RESERVED POWERS, DARTMOUTH-HITCHCOCK HEALTH (D-HH) SHALL HAVE THE AUTHORITY TO TAKE ACTIONS TO ESTABLISH, MANAGE, AND GOVERN MHMH TO CREATE AND MAINTAIN AN INTEGRATED HEALTH CARE DELIVERY SYSTEM IN FURTHERANCE OF THE MISSION OF MHMH AND OTHER ORGANIZATIONS WITHIN THE SYSTEM. THESE POWERS INCLUDE BUT ARE NOT LIMITED TO ITEMS SUCH AS THE ABILITY TO APPROVE, DISAPPROVE, OR MODIFY ALL MATERIAL GOVERNANCE, PROGRAMMATIC, AND FINANCIAL DECISIONS OF MHMH'S BOARD OF TRUSTEES, TO APPOINT OR REMOVE A MEMBER OF MHMH'S BOARD OF TRUSTEES, ASSESS MHMH A MONETARY AMOUNT FOR THE PAYMENT OF THE EXPENSES OF D-HH, APPROVE MHMH'S BUDGET, APPROVE THE BORROWINGS OR DISPOSITIONS OF ASSETS BY MHMH, APPROVE KEY STRATEGIC RELATIONSHIPS, APPROVE THE ELIMINATION OR ADDITION OF ANY MATERIAL HEALTH CARE SERVICE OR PROGRAM, AND OTHER AUTHORITY TO TAKE ACTION ON BEHALF OF MHMH.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyTHE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCIAL COMPLIANCE, THE VICE PRESIDENT OF CORPORATE FINANCE, THE CHIEF FINANCIAL OFFICER, AND EXTERNAL TAX ADVISORS BEFORE THE FILING OF THE RETURN. ONCE THE RETURN HAS BEEN FULLY PREPARED, A FINAL FORM 990 IS SENT TO EACH BOARD MEMBER AND TIME IS ALLOCATED FOR COMMENTS AND RESPONSES PRIOR TO OFFICIAL FILING.
Form 990, Part VI, Line 12c Conflict of interest policyTHE MARY HITCHCOCK MEMORIAL HOSPITAL BOARD OF TRUSTEES APPROVED A POLICY CONCERNING A VOLUNTARY SELF-DISCLOSURE OF ANY POTENTIAL CONFLICT OF INTEREST. THE DARTMOUTH-HITCHCOCK HEALTH (D-HH) COMPLIANCE AND AUDIT SERVICES DEPARTMENT CONDUCTS AN ANNUAL SURVEY OF ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES AND PERFORMS OTHER PROCEDURES AS CONSIDERED NECESSARY TO REPORT ON COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE DEPARTMENT THEN REPORTS TO EACH BOARD ANY POTENTIAL CONFLICTS FOR THEIR REVIEW. PER THE POLICY, ANY CONFLICTS OR OTHERWISE PERCEIVED CONFLICTS ARE REQUIRED TO BE ADDRESSED BY THE BOARD OF TRUSTEES ON AN ONGOING BASIS. IN THE EVENT A CONFLICT ARISES, THE INDIVIDUAL MAY BE REMOVED FROM PARTICIPATING IN ANY DECISION-MAKING REGARDING THE IDENTIFIED CONFLICT AND/OR ITS CORRESPONDING TRANSACTIONS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON ON THE BASIS FOR SUCH BELIEF AND AFFORD HIM/HER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT SUCH PERSON HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesCOMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS EVALUATED BY INTERNAL HUMAN RESOURCES STAFF USING NATIONAL BENCHMARKING DATA (ALONG WITH ONGOING EVALUATIONS BY AN INDEPENDENT THIRD-PARTY FIRM FOR REASONABLENESS). THE LAST FORMAL PROCESS WAS COMPLETED IN 2021. EXTERNAL BENCHMARKING FROM AN INDEPENDENT THIRD PARTY HAS BEEN USED FOR ANY OFFICER WHO WAS HIRED OR RECEIVED A COMPENSATION ADJUSTMENT SINCE THE LAST FORMAL PROCESS. COMPENSATION RATES ARE DETERMINED BY FOLLOWING THE GUIDELINES OF THE COMPENSATION COMMITTEE CHARTER AND PHILOSOPHY DOCUMENTS AND A FORMAL REVIEW BY COMPENSATION COMMITTEE MEMBERS. THE PROCESS DESCRIBED ABOVE TO ESTABLISH COMPENSATION WAS USED FOR THE FOLLOWING POSITIONS: Chief Financial Officer, Chief Strategy Officer, Chief Clinical Officer, Chief Legal Officer, Chief Human Resources Officer, Chief Operating Officer, Chief Nursing - Executive, Chief Nursing Officer, Chief Pharmacy Officer, Chief Quality & Value Officer, Department Chair - Anesthesia, Department Chair - Radiology, Department Chair - Pathology and similar positions.
Form 990, Part VI, Line 19 Required documents available to the publicMHMH'S GOVERNING DOCUMENTS ARE AVAILABLE THROUGH THE NEW HAMPSHIRE SECRETARY OF STATE. THE AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST EITHER IN ELECTRONIC OR HARD COPY FORM.
Form 990, Part VII, Section A, Line 1a, Column (B) AVERAGE HOURS PER WEEKAS PART OF DARTMOUTH-HITCHCOCK CLINIC AND MARY HITCHCOCK MEMORIAL HOSPITAL'S AFFILIATION AGREEMENT, THE TWO ORGANIZATIONS SHARE OFFICERS. AS SUCH, THE AVERAGE HOURS PER WEEK ARE ALLOCATED BETWEEN THE TWO ORGANIZATIONS' FORMS 990 EVEN THOUGH COMPENSATION REPORTED IN PART VII IS BASED ON THE ENTITY ISSUING THE W-2. IN ADDITION, CERTAIN OFFICERS SPEND TIME ON DARTMOUTH-HITCHCOCK HEALTH (THE SOLE CORPORATE MEMBER OF BOTH MHMH AND DHC), AND/OR DARTMOUTH-HITCHCOCK CLINIC ALONG WITH OTHER AFFILIATED ORGANIZATIONS: DARTMOUTH-HITCHCOCK MEDICAL CENTER, HAMDEN RISK RETENTION GROUP (AND RELATED ENTITIES), ALICE PECK DAY MEMORIAL HOSPITAL, WINDSOR HOSPITAL CORPORATION (DBA MT ASCUTNEY HOSPITAL AND HEALTH CENTER), MT. ASCUTNEY HOSPITAL COMMUNITY HEALTH FOUNDATION, HISTORIC HOMES OF RUNNEMEDE, CHESHIRE MEDICAL CENTER, CHESHIRE HEALTH FOUNDATION, CHESHIRE HEALTH SERVICES, THE NEW LONDON HOSPITAL ASSOCIATION, VNA & HOSPICE OF VT AND NH, AND THE HITCHCOCK FOUNDATION.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesNET ASSET TRANSFER FROM AFFILIATES - 9142911; PENSION-RELATED AND OTHER CHANGES - 15595395; NET ASSET RELEASED FROM RESTRICTION - -13684962;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
NEW ENGLAND ALLIANCE FOR HEALTH LLC
ONE MEDICAL CENTER DRIVELEBANONNH03756264232401HEALTH IMPROVEMENTNH$222,013$897,250MHMH
D-H SPECIALTY SERVICES LLC
ONE MEDICAL CENTER DRIVELEBANONNH03756460876427SHARED SAVINGS PROGRAMNH$0$0MHMH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
DARTMOUTH-HITCHCOCK CLINIC
ONE MEDICAL CENTER DRIVELEBANONNH03756222519596PHYSICIAN SERVICESNH501(c)(3)10D-HHfalse
DARTMOUTH-HITCHCOCK HEALTH
ONE MEDICAL CENTER DRIVELEBANONNH03756264812335PARENT ORGANIZATIONNH501(c)(3)7NAfalse
THE NEW LONDON HOSPITAL ASSOCIATION INC
273 COUNTY ROADNEW LONDONNH03257020222171HOSPITALNH501(c)(3)3D-HHfalse
WINDSOR HOSPITAL CORPORATION
289 COUNTY ROADWINDSORVT05089030183721HOSPITALVT501(c)(3)3D-HHfalse
CHESHIRE MEDICAL CENTER
580 COURT STREETKEENENH03431020354549HOSPITALNH501(c)(3)3D-HHfalse
ALICE PECK DAY MEMORIAL HOSPITAL
10 ALICE PECK DAY DRIVELEBANONNH03766020222791HOSPITALNH501(c)(3)3D-HHfalse
VISITING NURSE ASSOCIATON AND HOSPICE OF VERMONT AND NEW HAMPSHIRE INC
88 Prospect StreetWhite River JuctionVT05001036006494HOSPICEVT501(c)(3)10D-HHfalse
DARTMOUTH -HITCHCOCK MEDICAL CENTER
ONE MEDICAL CENTER DRIVELEBANONNH03756222715483SUPPORTING ORGANIZATIONNH501(c)(3)Type INAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1DARTMOUTH-HITCHCOCK MASTER INVESTMENT PROGRAM OF POOLED INVESTMENT ACCOUNTSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 MED CTR DRAddressLine1Txt
CityLEBANONCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03756ZIPCd
FieldValueIRS element (for citing)
EIN020205863EIN
Primary ActivitiesPOOLED INVESTMENTSPrimaryActivitiesTxt
Legal Domicile StateNHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MHMHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeExcludedPredominantIncomeTypeTxt
Share Of Total Income$103,225,245ShareOfTotalIncomeAmt
Share Of EOY Assets$745,077,257ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
UBI Code V-$453,512UBICodeVAmt
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd
Ownership0.7082OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd